锁定钢板与解剖型钢板治疗股骨远端骨折的疗效及安全性比较

Efficacy and safety of locking plate and anatomical plate in treatment of distal femoral fracture

目的:比较锁定钢板与解剖型钢板治疗股骨远端骨折的临床效果及安全性。方法:选取2005年3月～2009年5月收治的115例股骨远端骨折患者作为研究对象,按照内固定方法不同分为A组(锁定钢板)55例和B组(解剖型钢板)60例,比较两组患者手术时间、术中出血量、术后并发症、术后膝关节功能评分等情况。结果:两组患者手术时间比较无统计学差异(P>0.05),术中出血量、骨折愈合时间、术后住院时间、术后并发症比较有统计学差异(P<0.01)。随访观察12个月,按照Kolmert膝关节功能评分标准,A组优32例,良19例,可3例,差1例,优良率为92.7%;B组优28例,良21例,可9例,差2例,优良率为81.7%。两组患者膝关节功能优良率比较有统计学差异(P<0.01)。结论:锁定钢板内固定治疗股骨远端骨折较解剖型钢板更加适合,其具有创伤小、术后恢复快、并发症少、膝关节功能恢复好等优点,值得推广应用。

Objective： To compare efficacy and safety of locking plate and anatomical plate in treatment of distal femoral fractures. Methods： A total of 115 cases with distal femoral fractures admitted from March 2005 to May 2009!, were divided into group A （Locking plate, 55 eases） and group B （Anatomical plate, 60 cases） according to different internal fixation methods. Operation time, intraoperative blood loss volume, postoperative complications, postoperative knee function scores ete were determined and compared. Results： There was no significant difference in operation time （P〉0. 05）, while the differences in intraoperative blood loss volume, fracture healing time, postoperative hospital stay, and postoperative complications were significant （P〈0.01）. The follow-up duration was 12 months. According to Kolmert knee function e-;aluation standard, there were 32 excellent cases, 19 good cases, 3 fine cases and 1 poor case in group A, the excdllent and good rate was 92.7%; while there was 28 exeellent eases, 21 good cases, 9 fine cases, and 2 poor cases, the excellent and good rate was 81.7% in group B. The difference in good rate of knee joint function was significant （P〈0.01）. Conclusions： Locking plate fixation is of less trauma, faster postoperative recovery, less complications, and good functional recovery of knee joint. It is more suitable for the treatment of distal femoral fracture than anatomical plate, and is worthy of extensive application.