股骨远端复杂骨折术中下肢力线恢复方法的研究

Restoration of the axial alignment of the lower extremity during operation of complex fractures of distal femur

目的探讨股骨远端复杂骨折术中下肢力线的恢复与疗效分析。方法自1999牟5月至2005年9月共手术治疗35例股骨远端复杂骨折，其中男30例，女5例，平均47．5岁。骨折分型：MullerA3型10例，C2型18例，C3型7例，均行切开复位钢板内固定植骨，同时注意恢复正常的下肢力线。下肢力线的恢复以健侧为参照标准。测量方法：自髂前上棘至第1、2趾间拉一直线，计算髌骨中心至该直线的垂直距离，并与健侧比较。结果35例患者中30例获得随访，随访时间14—36个月，平均21个月，按Rasmussen膝关节评分标准，结果：优20例，良5例，可3例，差2例，优良率达83．3％，膝关节功能与下肢力线正常与否密切相关。结论术中下肢力线的纠正是膝关节功能恢复的重要保证，同时，要充分考虑导致术后下肢力线异常的主要因素并给予相应处理。

Objective To investigate the axial alignment of the lower extremity during operation forcomplex fractures Of clistal femur and to assess the curative effect. Methods A retrospective analysis of 30 cases of complex fractures of distal femur were conducted from May 1999 to September 2005,30 male and 5 female,mean age was 47.5. The type of fractures： 10 cases were Muller A3 ,18 were type C2 ,7 were type C3. All cases were treated with open reduction, bone graft and internal - fixation with plate and screw, and the normal axial alignment of the lower extremity was restored. The restoration standard was in accordance with the uninjured side limb. The way of measuremend ： the axial line from anterior superior iliac to interdigit of the first and second toe was done, then, the perpendicular distance from the center of patella to this line was calculated, and compared the date with uninjured side limb＇ s. Results Thirty cases were followed up ,from 14 months to 36 months, average 21 months, according to the Rasmussen knee score standard ,20 were excellent ,7 were good ,2 were fair and 1 was poor. The satisfactory rate was 90% , the restoration of knee function were close correlated with whether the line normal or not. Conclusions It is very important that the axial alignment of the lower extremity to be corrected during operation to the injured knee function restoration after operation, and the causes result in the axial line abnormal above - mentioned shoud be considered thoroughly, at the same time, the corresponding measures should be taken.