逆行交锁髓内钉和解剖钢板内固定治疗股骨远端骨折的疗效对比

Comparison between retrograte interlocking intramedullary nail and anatomical plate fixation in the treatment of distal femoral fractures

目的分析逆行交锁髓内钉和解剖钢板内固定治疗股骨远端骨折的疗效。方法2003年1月至2008年1月手术治疗股骨远端骨折68例，采用逆行交锁髓内钉内固定35例，采用解剖钢板内固定33例。用Mer-chant膝关节功能评定标准判定疗效，分析两组骨折类型、手术时间、术后开始功能锻炼的时间、内固定术式等因素与最终功能的关系。结果68例均获得6～36个月（平均18个月）随访，其中3例发生骨折不愈合。采用Merchant膝关节功能评定标准判定疗效：优35例，良21例，可9例，差3例，优良率82．4％。结论股骨远端骨折粉碎及移位的程度直接影响预后。合适的手术时机，合适的内固定，术中解剖复位，术后功能锻炼是提高疗效的重要因素。

Objective To compare the efficiency between retrograte interlocking intramedullary nail and anatomical plate fixation in the treatment of distal femoral fractures. Methods From January 2003 to January 2008, 35 cases of 68 patients of distal femoral fractures were treated by retrograte interlocking iutramedullary nail, and the other 33 cases were treated by anatomical plate fixation, according to Merchant＇s cale to study two groups on fracture patterns, operation time, time beginning function exercise after operation, fixation type and other factors and the final function. Results All the cases were followed up for 6 to 36 months（ average 18 months）. 3 cases of the fractures didn＇t get united. The functions were excellent in 35 eases,good in 21 cases,fair in 9 cases, and poor in 3 cases according to Merchant＇s cale. The excellent and good rate was 82. 4%. Conelusion Comminuted fractures of distal femur and the condition of the bone affect the prognosis directly. The opportunity of operation, appropriate internal fixation, intraoperative anatomic reduction, function exercise after operation are the important factors to improve the efficiency.