单钢板与内外侧双钢板固定治疗股骨远端C3型骨折疗效比较

The effect analysis between single-plate internal fixation with lateral & medial-plates internal fixation of the type C3 fractures of distal femur

目的比较单钢板与内外侧双钢板固定治疗股骨远端c3型骨折的临床疗效。方法将87例股骨远端c3型骨折按治疗方法分为单钢板固定组（41例）和双钢板固定组（46例），对手术后骨折稳定性、骨折愈合情况、功能锻炼时间以及术后3个月关节活动度进行比较。结果87例均获随访，时问3～24个月。单钢板固定组5例术后3周内出现内侧骨折块移位，其中4例骨折不愈合，3例植骨后愈合，1例钢板断裂、骨不连；双钢板固定组未出现上述并发症，两组比较差异有统计学意义（P〈0．05）。术后开始功能锻炼时间：单钢板固定组为15～28（19±6）d，双钢板固定组为2～5（3±1）d，差异有统计学意义（P〈0．05）。术后3个月膝关节活动度：单钢板固定组为60°～95°（75°±15°），双钢板固定组为90°～120°（100°±10°），差异有统计学意义（P〈0．05）。结论股骨远端c3型骨折行内外侧双钢板固定治疗，可以明显提高临床疗效，减少术后并发症。

Objective To compare the difference of clinical effect between single-plate internal fixation with lateral ＆ medial-plates internal fixation of the type C3 fractures of distal femur. Methods 87 cases of type C3 fractures of fe- mur distal were divided into 2 groups accroding to the treatment： one was the single-plate group （41cases）, the other was double-plates （46 cases）. The differences of the fractures stability, union of fractures , time of training, and knee joint motions were compared 3 months postoperation. Results 87 cases all were followed-up for 3 - 24 months. In the single-plate group, there were 5 cases appeared with medial bone fragment dislocating in 3 weeks postopera- tion, among them 4 got nonunion, and 3 got union after bone grafting, 1 with plate broken ; The group of double-plates have no complications such as above-mentioned, compared in the 2 groups, the divergence was a meaning of statistics （P 〈0. 05 ）. The training time of single-plate treated cases was 15 -28 （19 ±6）d, while the group of double-plates was 2 - 5 （3 ± 1 ） d, the divergence was a meaning of statistics （ P 〈 0. 05 ）. The knee joint motions 3 months postopera- tion of the single-plate group was 60° -95° （75° ± 15 ° ） , while of the double-plates group was 90°- 120° （ 100°± 10°）, the divergence was a meaning of statistics （P 〈 0. 05 ）. Conclusions The treatment of lateral ＆ medical plates to type C3 fractures of femur distal can improve the clinical effect obviously, and reduce the fracture complica- tions postoperation.