锁定钢板固定治疗股骨髁间髁上粉碎骨折

Treatment of comminuted supra-and intercondylar fracture of the femur using locking plate internal fixation

目的：探讨锁定钢板固定治疗股骨髁间髁上粉碎骨折的临床疗效。方法采用锁定钢板固定治疗28例股骨髁间髁上粉碎骨折患者，术后均积极进行康复训练。结果5例失访，23例获得随访，时间6个月～2年。伤口感染1例，经再次手术冲洗引流后痊愈；钢板松动、髁上骨折未愈1例，经再次手术锁定钢板固定并髁上植骨后痊愈。23例骨折均愈合，时间6～18个月。术后4周时21例患者主动活动度＞90＆#176;。按Evanich评分评价膝关节功能：优13例，良8例，可2例。结论锁定钢板内固定治疗股骨髁间髁上骨折简单、方便、有效，早期规范的功能训练是膝关节功能恢复的保证。

Objective To explore the effects of surgical treatment on comminuted supra-and intercondylar fractures of the femur using locking plate fixation.Methods Twenty-eight patients with comminuted supra- and intercondylar fractures of the femur were treated by locking plate fixation.All cases started functional training on the right postoper-ative day.Results 23 cases were followed up for 6~24 months while 5 cases were lost to follow-up.1 case occurred wound infection,and cured after washing and drainage;1 case got looseness and nonunion,and healed after locking plate fixation and supracondylar bone transplantation.23 cases got fracture healing,and the healing time was range from 6 to 18 months.21 cases achieved knee join movement surpass 90 degree.The evaluation of results according to Evanich scoring system was excellent in 13 cases,good in 8 and fair in 2.Conclusions The locking plate fixation is an ideal surgical treatment on comminuted supra-and intercondylar fractures of the femur for it is a easy,convenient and effective operation,while early and normative functional training is a key factor that helps knee function recovery.