应用AO特殊钢板治疗近关节骨折(附45例报告)

Treatment of Extremital Fracture near Articulation using AO Special Plate

目的 :探讨AO特殊钢板在肢体近关节骨折的治疗效果。方法 :1998年 6月以来应用AO特殊钢板治疗肢体近关节骨折 45例 ,其中股骨粗隆部骨折 2 8例用动力髋螺钉 (DynamicHipScrew ,DHS)固定 ;股骨髁上、髁间骨折 7例用髁钢板及动力髁螺钉 (DynamicCondyleScrew ,DCS)固定 ;Pilon骨折 6例用 1/ 3环形腓骨钢板及三叶蓿形支持钢板固定 ;肱骨外科颈骨折 4例用T形支持钢板固定。结果 :平均随访 10个月 ,股骨粗隆间及髁上髁间骨折 ,肱骨外科颈骨折在术后 3～ 4个月骨愈合 ,Pilon骨折有 4例在术后 6个月骨愈合。本组未出现手术并发症 ,关节功能恢复满意。结论 :AO特殊钢板设计合理 ,组织相容性好 ,对复杂近关节骨折能起到坚强固定 ,满足关节早期功能锻炼的作用 ,疗效优良。

Objective:To evaluate the results of AO special plate in the treatment of extremital fracture near articulation.Methods:Since June 1998,45 cases of extremital fractures near articulations were operated by AO special plates.Among them,28 patients of intertrochanteric fractures were treated with Dynamic Hip Screw(DHS);7 patients of supracondylar and intercondylar fractures of femur were treated with Dynamic Condylar Screw(DCS);6 cases of Pilon fractures were operated with one third circular plates and Medicago sativa plates,and 4 cases of fractures of surgical neck of humerus were used T shaped plates.Results:The mean duration of the follow up was 10 months.Bone healing was seen at 3～4 months in the fractures of intertrochanteric,femoral condyle and humeral surgical neck,at 6 months in 4 cases of Pilon fractures.Other 2 cases of Pilon fractures had porotic stage at 2～3 months after operation.There was no operative complications in these cases.Recovery of articular function was satisfactory.Conclusion:AO special plate had a rational design and a good histocompatibility.It possessed enough stability meeting the need of early functional exercise and was very suitable for complicated fracture near articulation.