内固定治疗股骨远端骨折的临床分析

Clinical Analysis on Interior Fixation of Distal Thighbone Fracture

目的 探讨股骨远端各型骨折内固定的方法。方法 对76例股骨远端骨折分别选用股骨逆行交锁髓内钉治疗21例、动力髁螺钉治疗31例、AO支撑钢板治疗24例。结果 随访9～24个月，全部病例均骨性愈合，其中优41例、良29例、一般5例、差1例，优良率92％。结论 治疗股骨远端骨折的方法各有优缺点，治疗上互不替代，逆行交锁髓内钉适用于无明显骨缺损髁上骨折（A1、A2型）；动力髁螺钉适用于髁上有碎折块的低位髁上骨折、单纯外髁及Y型髁间骨折（A3、B1、B2、C1型）；AO支撑钢板适用于髁间碎裂严重的C2、C3型骨折。

Objective To discuss the methods of internal fixation for the distal thighbone fracture. Methods Among all 76 cases with distal thighbone fracture, 21 cases were treated with retrograde intramedullary supralondylar nail, 31 cases with dynamic condylar screw （DCS） and 24 cases with AO buttress condylar plate respectively. Results All cases were healed with excellent results in 41, good in 29, fair in 5 and bad in 1. The rate of excellent and good was 92%. Conclusions The three methods have their owns advantages and disadvantages in the treatment of the distal thighbone fracture. Retrograde intramedullary supralondylar nail is suitable for condylus fracture which has no obvious bone defect （types A1 and A2）. DCS is suitable for condylus fracture which has broken bits, purely external condylus fracture and type Y fracture between condylus（ types A3, B1, 132 and C1 ） ; AO buttress condylar plate is suitable for fracture between condylus which was broken seriously （ types C2 and C3 ）.