前正中切口联合微创内固定系统双钢板固定C3型股骨远端骨折的疗效分析

发布时间：2018-03-31 02:02

本文选题：股骨远端骨折　切入点：骨折内固定术　出处：《第三军医大学学报》2017年17期

【摘要】：目的探讨前正中切口联合微创内固定系统(less invasive stabilization systems,LISS)双钢板固定AO-C3型股骨远端骨折的临床疗效。方法筛选2014年6月至2017年3月我科采用膝关节置换术中常用的前正中切口联合LISS双钢板固定治疗AO-C3型股骨远端骨折的患者18例,其中男性12例,女性6例,年龄19~62岁。包括交通伤11例,高坠伤7例;6例为开放性骨折,12例为闭合性骨折。最后1次随访中采用Kolment和Wulff(1982)治疗评价标准评定内固定术后膝关节功能。结果18例患者手术时间平均145(110~200)min,术后均获得17.5(12~25)个月随访,术后骨折平均愈合时间22(20~26)周,骨折全部愈合,未出现骨折不愈合、感染、骨髓炎及神经血管损伤等并发症。对末次随访患者按照Kolment和Wulff(1982)治疗评价标准进行评估:优6例,良9例,可2例,差1例,优良率达83.33%。结论采用的膝关节前正中切口可充分暴露股骨远端关节面,术中显露清晰,便于关节面骨折的解剖复位,可一期处理关节内结构损伤,同时联合LISS双钢板牢固固定骨折,避免对骨折断段软组织的过多剥离,允许术后即刻进行有效的早期功能锻炼,可以取得良好的疗效。
[Abstract]:Objective to investigate the clinical effect of anterior median incision combined with minimally invasive internal fixation system (invasive stabilization system list) for the treatment of distal femur fractures of AO-C3 type with double plate. Methods from June 2014 to March 2017, we selected the anterior orthopedic fractures commonly used in knee arthroplasty in our department. 18 patients with distal femur fracture of AO-C3 type were treated with middle incision and LISS double plate fixation. There were 12 males and 6 females aged 1962 years, including 11 traffic injuries. In the last follow-up, the knee joint function after internal fixation was evaluated by Kolment and Wulff's 1982.Results the average operation time of 18 patients was 145 ~ 110200 min, and all patients were followed up for 17.5 ~ 1225 months. The average healing time was 22 ~ 20 ~ 26) weeks, and the fracture healed completely, without complications such as nonunion, infection, osteomyelitis and neurovascular injury. According to the criteria of Kolment and Wulff-1982), the last follow-up patients were evaluated: excellent in 6 cases, excellent in 6 cases. Good, fair and poor in 9 cases, fair in 2 cases, poor in 1 case, the excellent and good rate was 83.33.Conclusion the anterior and middle incision of knee joint can fully expose the distal femoral articular surface, expose clearly during the operation, facilitate the anatomical reduction of the fracture of the articular surface, and can deal with the intraarticular structure injury in one stage. At the same time, combined with LISS double plate fixation of fracture, avoiding excessive exfoliation of broken soft tissue, allowing effective early functional exercise immediately after operation, can achieve good results.
【作者单位】：重庆市巴南区人民医院骨科;
【分类号】：R687.32

【相似文献】