桥接组合式内固定治疗股骨远端骨折的疗效分析
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摘要
目的探讨桥接组合式内固定系统治疗股骨远端骨折的疗效。方法合肥市滨湖医院骨科2009年12月至2014年1月采用桥接组合式内固定系统治疗股骨远端骨折病人31例,其中男性23例,女性8例;年龄(38.5±6.3)岁,年龄范围为28～61岁;评估手术时间、出血量、骨折愈合时间及肢体功能恢复情况,分析桥接组合式内固定系统在股骨远端骨折治疗中的临床疗效。结果病人术后获得随访的时间(15.6±3.4)个月,时间范围为9～36个月;骨折的愈合时间(4.5±2.8)个月,愈合时间范围为3～7个月。所有病人均获骨性愈合。末次随访时病人膝关节活动度为(123±9.1)°,膝关节活动度范围为100°～130°。膝关节功能按美国特种外科医院膝关节评分系统评分为(92.3±3.7)分,评分范围为89～96分。Sanders肢体功能评价,优24例,良4例,可3例,优良率90.3%。所有病人术后均无感染、骨折不愈合及内固定装置机械故障等合并症的发生。结论桥接组合式内固定系统能为股骨远端骨折提供可靠的内固定,并允许病人早期进行功能锻炼,是治疗股骨远端骨折的有效方法之一。
Objective To evaluate the clinical effects of bridge combined fixation system for distal femoral fracture.Methods From December 2009 to January 2014,31 patients(23 males,8 females) with distal femoral fracture whose age ranged from 28 to 61 years(mean,38.5±6.3 years) were cured by bridge combined fixation system.Operation time,blood loss,fracture healing time and the recovery of limb function were evaluated.The clinical effects of bridge combined fixation system for distal femoral fracture were analyzed.Results The followed-up time ranged from 9 to 36 months(mean,15.6±3.4 months),the fracture healing time ranged from 3 to 7 months(mean,4.5±2.8 months).In the last follow-up,the range of knee motion ranged from 100° to 130°(mean,123±9.1°).The HSS(Hospital for special surgery knee score) score ranged from 89 to 96(mean,92.3±3.7).Sanders limb function evaluation showed:excellent in 24 cases,good in 4 cases,average in 3 cases,with an excellent and good rate of 90.3%.No complications,such as wound infection,fracture nonunion,internal fixator failure,were observed.Conclusion Bridge combined fixation system,which can provide reliable internal fixation and allowed early dirigation is an effective method to cure distal femoral fracture.
Objective To evaluate the clinical effects of bridge combined fixation system for distal femoral fracture.Methods From December 2009 to January 2014,31 patients(23 males,8 females) with distal femoral fracture whose age ranged from 28 to 61 years(mean,38.5±6.3 years) were cured by bridge combined fixation system.Operation time,blood loss,fracture healing time and the recovery of limb function were evaluated.The clinical effects of bridge combined fixation system for distal femoral fracture were analyzed.Results The followed-up time ranged from 9 to 36 months(mean,15.6±3.4 months),the fracture healing time ranged from 3 to 7 months(mean,4.5±2.8 months).In the last follow-up,the range of knee motion ranged from 100° to 130°(mean,123±9.1°).The HSS(Hospital for special surgery knee score) score ranged from 89 to 96(mean,92.3±3.7).Sanders limb function evaluation showed:excellent in 24 cases,good in 4 cases,average in 3 cases,with an excellent and good rate of 90.3%.No complications,such as wound infection,fracture nonunion,internal fixator failure,were observed.Conclusion Bridge combined fixation system,which can provide reliable internal fixation and allowed early dirigation is an effective method to cure distal femoral fracture.
引文
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[9] 熊鹰,陆继鹏,李群辉,等.桥接组合式金属内固定植入系统对犬骨折愈合的影响[J] .中国组织工程研究与临床康复,2011,15(30):5556-5560.
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[11] K?SEO,BILGEN MS,et al.Comparison of two biological internal fixation techniques in the treatment of adult femur shaft fractures (plate-screws and locked intramedullary nail)[J].Ulus Travma Acil Cerrahi Derg,201,17(2):159-165.
[12] PAPAKOSTIDIS C,GROTZ MR,PAPADOKOSTAKIS G,et al.Femoral biologic plate fixation[J].Clin Orthop Relat Res,2006,450:193-202.
[2] OZKAN K,UNAY K,DEMIRCAY C,et al.Distal unlocked proximal femoral intramedullary nailing for intertrochanteric femur fractures [J].Int Orthop,2009,33(5):1397-1400.
[3] 柳昊,郭风劲,陈安民,等.股骨远端骨折不同内固定方法的疗效分析[J].中国骨与关节损伤杂志,2009,24(12):1057-1060.
[4] SANDERS R,REGAZZONI P.Treatment of subtrochanteric femur fractures using the dynamic condylar screw[J].J Orthop Trauma,1989,3(3):206-213.
[5] HELFET DL,LORICH DG.Retrograde intramedullary nailing of supracondylar femoral fractures[J].Clin Orthop Relat Res,1998,350(1):80-84.
[6] 刘亚波,孙林,刘德全,等.股骨远端骨折的手术治疗[J].中华创伤骨科杂志,2004,4(1):209-211.
[7] 田勇,卡索.股骨远端骨折的研究进展[J].中国矫形外科杂志,2006,12(12):936.
[8] 赵烽,熊鹰,张仲子,等.桥接组合式内固定治疗股骨骨折的效果及生物力学特征[J].中国组织工程研究,2014,18(13):2127-2132.
[9] 熊鹰,陆继鹏,李群辉,等.桥接组合式金属内固定植入系统对犬骨折愈合的影响[J] .中国组织工程研究与临床康复,2011,15(30):5556-5560.
[10] 陆继鹏,熊鹰,李群辉,等.桥接组合式内固定系统对骨折端血供的影响[J].中国矫形外科杂志,2013,21(12):1210-1214.
[11] K?SEO,BILGEN MS,et al.Comparison of two biological internal fixation techniques in the treatment of adult femur shaft fractures (plate-screws and locked intramedullary nail)[J].Ulus Travma Acil Cerrahi Derg,201,17(2):159-165.
[12] PAPAKOSTIDIS C,GROTZ MR,PAPADOKOSTAKIS G,et al.Femoral biologic plate fixation[J].Clin Orthop Relat Res,2006,450:193-202.