动力髁螺钉与微创内固定系统治疗股骨远端骨折疗效的比较

Comparison between dynamic condyle screw and minimally invasive stabilization system for distal femoral fracture

目的:比较动力髁螺钉(DCS)与微创内固定系统(LISS)治疗股骨远端骨折的疗效。方法:对DCS组(38例)和LISS组(23例)患者临床资料和影像结果进行回顾性对比分析。结果:两组患者术后无感染,切口均一期愈合。本资料总的骨折愈合率为93.4%(57/61),DCS组与LISS组愈合率分别为94.7%(36/38)和91.3%(21/23()p=0.643),平均愈合时间分别为20.3周(16-29)和19.5周(16-26)(p=0.856)。膝关节功能按Merchant评分标准,DCS组与LISS组优良率分别为94.7%(36/38)和95.7%(22/23)(p=0.772)。早期螺钉松动(术后12周内)只发生在DCS组(7.9%,p=0.236,OR=1.753[95%CI:1.302-2.415])。结论:DCS和LISS治疗股骨远端骨折均取得良好的疗效,LISS装置早期松动的风险似乎低于DCS。

Objective：To outline any differences in clinical and radiological results between the dynamic condyle screw（DCS） and less invasive stabilization system（LISS） for treating distal femoral fractures.Methods：The data of the clinical and radiographic outcomes were compared between the DCS group（38 cases） and LISS group（23 cases）.Results：Complete union was achieved in 57 of the 61 patients（93.4%）.The success rate of the DCS group and LISS group was 94.7% and 91.3%（p =0.643） respectively.The mean fusion time was 20.3 weeks in the DCS group and 19.5 weeks in the LISS group（p= 0.856）.According to the scoring systems of Merchant,the excellent and good rate was 94.7% in the DCS group and 95.7% in the LISS group（p =0.772）.Early implant failure only occurred in the DCS group（7.9%,p=0.236,odds ratio=1.7536 [95% CI：1.302-2.415]）.Conclusions：Minimally invasive percutaneous plating with the DCS or the LISS achieved good outcome with few complications in the treatment of distal femoral fractures.LISS seems to have lower risk of early implant loosening than the DCS.