基层医院股骨远端骨折的治疗分析

Treatment analysis of distal femoral fractures in primary hospital

目的分析基层医院治疗股骨远端骨折的治疗方法的临床效果。方法选择本院2000年1月～2012年6月收治的58例股骨远端骨折患者,其中,男性39例,女性19例,根据AO/ASIF分型,其中,A型13例,B型24例,C型21例,随机分为观察组和对照组,对照组采用保守治疗,观察组实施手术治疗,术后随访6～38个月。结果根据Kolment股骨远端功能评定标准,观察组和对照组在膝关节的伸直和屈曲度均有所恢复,观察组膝关节活动度为50°～135°,平均110°,骨折愈合率为90.48%;对照组膝关节活动度为35°～125°,平均95°,骨折愈合率为72.97%;观察组的骨折愈合率高于对照组,且差异具有统计学意义(P<0.05)。在治疗效果方面,观察组总有效19例,总有效率为90.48%;对照组总有效27例,总有效率为72.97%;观察组在显效率和总有效率方面均显著高于对照组,差异具有统计学意义(P<0.05)。结论实施手术治疗股骨远端骨折能够最大限度地提高骨折愈合的恢复和质量,提高日常生活活动能力,治疗股骨远端骨折效果显著,值得临床上推广使用。

Objective To analyze the treatment methods and clinical effect of distal femoral fractures in primary hospital. Methods Fifty eight patients with distal femoral fractures admitted to our hospital from January 2000 to June 2012 （39 eases of males, 19 eases of females; 13 cases of Type A, 24 eases Type B, and 21 eases Type C, according to AO/ASIF Typing） were selected and randomly assigned into observation group （surgical treatment） and control group （conservative treatment）. Post-operative follow up was continued for 6 to 38 months. Results According to the Kolment function assessment standard of distal femur, both groups were improved in both knee extension and flexion recovery. In observation group, the knee movement angles were 50°-135°, mean 110°, fracture healing rate was 90.48%; while in control group, the knee movement angles were 35°-125°, mean 95°, fracture healing rate was 72.97%. The fraeture healing excellent rate of observation group was higher than that of control group with statistically significant difference （P 〈 0.05）. As to the treatment effeet, there were 19 eases of total effect with total effective rate of 90.48%, while 27 eases and 72.97% in control group. The showing effect rate and total effective rate of observation group were markedly higher than those of control group with statistically significant difference （P 〈 0.05）. Conclusion For distal femoral fracture, surgical treatment can maximally improve the quality of fracture healing and activity of daily life, has significant effect, and is worthy of widely applying.