椎间盘镜系统辅助与切开直视逆行髓内钉固定治疗股骨远段骨折的对比研究

Microendoscopy-assisted retrograde interlocking nail versus direct vision operation in treatment of fracture of distal femur

[目的]比较椎间盘镜辅助下和切开直视下逆行髓内钉固定治疗股骨远段骨折的疗效,探讨椎间盘镜辅助下逆行髓内钉固定治疗股骨远段骨折的优越性。[方法]2004年8月~2008年8月本院共收治股骨远段骨折患者52例,其中32例采用椎间盘镜辅助下逆行交锁髓内钉内固定,20例采用切开直视下逆行交锁髓内钉内固定;评价两种方法的手术时间、出血量、骨愈合时间及膝关节功能。[结果]52例患者术后随访10~26个月,平均16个月。两组在手术时间、术中出血、功能评价方面差异有显著性(P<0.05),其中膝关节功能按Kolment评定标准,椎间盘镜组优良率93.8%,切开组优良率65.0%;两组在骨折愈合时间上差异无显著性(P>0.05)。[结论]椎间盘镜辅助与直视切开下股骨逆行交锁髓内钉相比,具有手术时间短、创伤小,并发症少等优点,有利于膝关节功能恢复。

[ Objective ] To compare and analyze the clinical outcomes of microendoseopy-assisted retrograde interlocking nail versus direct vision operation in the treatment of distal femur fracture, and to explore advantages of the former. [ Method ] Fifty-two cases were analyzed with distal femur fracture from Aug. 2004 to Aug. 2008. Of them,32 were treated with microendoscopy-assis- ted retrograde interlocking nail,while 20 cases with interlocking nail under direct vision. Then operation time,intraoperative blood loss, bone union time, and the knee functiol~ were compared and evaluated. [ Result] All cases were followed up from 10 to 26 months （mean 16 months）. There was significant difl^rence in statistics in blood loss, mean operation time and knee function sco- ring（P 〈 0.05）. According to Kolment scoring, the excellent and good result rate in microendoscopy-assisted group was 93.8% , while in direct vision group was 65.0%. There wasn＇ t significant difference in bone union time （ P 〉 0.05 ）. [ Conclusion ] Micro- endoscopy-assisted retrograde interlocking nail compared to the method of direct vision operation has obvious advantages in less blood loss during operation, and better function recovery after operation for distal femur fracture.