钢板、逆行髓内钉治疗股骨髁上骨折比较

Comparison of intramedullary nail with compression plate for the treatment of femoral supracondylar fracture

目的观察利用逆行髓内钉和加压钢板治疗股骨髁上骨折,探求一种更好的治疗方法。方法2003年6月至2007年6月对18例股骨髁上骨折行逆行髓内钉治疗,余20例采用加压钢板治疗,对它们的疗效进行对比、分析。结果逆行髓内钉固定术后骨折全部临床愈合,愈合时间3～5个月,平均3个月。髋、膝关节伸屈功能及行走基本正常,无髓内钉断裂及再发骨折等并发症发生。用加压钢板内固定术后,出现骨折延迟愈合1例,内固定松动拔钉2例。两种方法相比,差异有统计学意义(<0.05)。结论髓内钉具有轴向加压、抗分离和抗旋转的功能,手术操作简便,不损伤骨外膜,是治疗股骨髁上骨折一种有效的手段。

Objective To explore a better method of treatment of femoral supracondylar fracture by comparing retrograde intramedullary nailing with compression plate on the therapeutic effect. Methods From June 2003 to June 2007, 18 cases of femoral supracondylar fractures used retrograde intramednllary nailing in the treatment, while 20 cases of femoral supracondylar fractures used compression plate in the treatment. And analyze the therapeutic effect through their comparison. ResuLts All case using retrograde intramedullary nail fixation are clinical healed, and rehabilitation time is 3 - 5 months, an average of 3 months. Hip and knee function and walking capability is normal, no complications such as intramedullary nail broken and fracture recurrence has happened. With compression plate fixation, one case delayed union, and two cases screw loosen. Two methods has the statistical significance difference（P〈0.05）. Conclusion Intramedullary nail that posses the function of axial compression, anti-separation and anti-rotation has no damage to outer membrane bone, it is an effective treatment of femoral supracondylar fracture.