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股骨远端骨折的手术治疗
Hits: 2019   Download times: 1203   Received:January 10, 2002    
作者Author单位UnitE-Mail
李山珠 LI Shan zhu 同济大学附属同济医院,上海200065 Tongji Hospital of Tongji University Shanghai,200065  
吴卫平 WU Wei ping 同济大学附属铁路医院  
蔡宣松 CAI Xuan song 同济大学附属同济医院,上海200065 Tongji Hospital of Tongji University Shanghai,200065  
期刊信息:《中国骨伤》2002年15卷,第11期,第656-658页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:评价不同内固定材料治疗股骨远端骨折的临床疗效。

方法:应用L形髁钢板,动力加压钉板,股骨远端解剖钢板和逆行股骨髁上交锁髓内钉等4种内固定材料治疗股骨远端骨折53例,其中随访12个月以上者44例(平均随访17月),采用X线检查及膝关节KSS评分评估治疗结果。

结果:本组44例患者,6例骨折对位欠佳,5例出现内固定松动、断裂,其中2例发生骨折不愈合,无一例发生感染。各内固定组的优良率分别是,L形髁钢板71.4%,动力加压钉板100%,解剖钢板88.9%,逆行交锁钉89.5%,各组间优良率无显著差异。

结论:4种内固定都能起到较好治疗效果,手术适应症选择得当和内固定材料的规范操作是关键。逆行股骨髁上交锁髓内钉适用于粉碎性骨折,解剖钢板适用于骨骺未闭合青少年骨折,动力加压钉板适用于“T”形和“Y”形骨折,L形髁钢板不作为治疗首选,可作为其他方法的补充选择。
[关键词]:股骨骨折  骨折固定术,内  外科手术
 
Surgical treatment of distal femoral fracture
Abstract:

Objective:To evaluate the clinical results of different internal fixation material for distal femoral fractures

Methods:53 cases of distal femoral fractures were treated with L condylar plate,dynamic compression plate and screw and IMSC nail respectively.Among them,44 patients were followed up for at leasL12 months(mean:17 months),which included 7 cases treated with L condylar plate,9 cases with dynamic compression plate and screw,and 19 cases with IMSC nail.The clinical results were evaluated through X ray and knee society clinical rating system.

Results:In these 44 cases,there were 6 slight malunions,5 loosening of and rupture of the internal fixation device and or 3 non unions.There was no infection.Good or excellent results were obtained in 71 4% of fractures with L condylar plate,100% with dynamic compress plate,88 9% and 89 5% with IMSC nails There was no significant difference among these groups.

Conclusion: Distal fractures can be managed effectively by any one of the four kinds of internal fixation;the key points of success are selecting suitable indications for operations and acting on operation principles.IMSC is suitable for use in comminuted fractures,anatomical plate is recommended for adolescent whomse epiphyseal growth plate closure not yet appeared,Dynamic condylar plate and screw are indicated for Y or T fractures,L blade plate is considered asupplement of other treatment.
KEYWORDS:Femoralfracture  Fracture fixation,internal  Surgery,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:李山珠,吴卫平,蔡宣松.股骨远端骨折的手术治疗[J].中国骨伤,2002,15(11):656~658
英文格式:LI Shan zhu,WU Wei ping,CAI Xuan song.Surgical treatment of distal femoral fracture[J].zhongguo gu shang / China J Orthop Trauma ,2002,15(11):656~658
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