复杂股骨远端骨折的治疗

Management of complex distal femoral fractures

复杂股骨远端骨折是指波及股骨远端干骺端及股骨髁的粉碎骨折,多由高能量损伤所致,临床治疗难度高、预后差。近些年,国内外学者对复杂股骨远端骨折的治疗进行了一系列的实验和临床研究,探索了包括复位技术、手术方式、内固定材料等诸多方面的进展并取得了一定成效,复位技术包括直视下复位与间接复位技术,手术和内固定方式包括常规切开复位内固定术、微创操作技术、髓内钉系统、钢板系统和假体置换等。该文围绕上述几个方面进行综述,以指导复杂股骨远端骨折的临床治疗。

Complex distal femoral fractures refer to those comminuted fractures which distal femoral metaphysis and femoral condyles are involved. Since mostly caused by high-energy injury, the management of complex distal femoral fractures remains difficult and the prognosis is poor. In recent years, a lot of experimental and clinical studies have been taken in and abroad to investigate the progress of reduction techniques, surgical methods, fixation materials and many other aspects in managing complex distal femoral fractures and some achievements have been reached. Reduction techniques can be divided into direct and indirect reduction, and surgical methods along with fixation techniques include traditional ORIF, minimally invasive operating techniques, intrameduUary nails, screw-plate system and prosthetic replacement. In this article, a review will be made around those aspects above to provide a guideline of the clinical management of complex distal femoral fractures.