平乐正骨手法结合现代器械复位治疗股骨骨折的疗效分析

Efficacy of Pingle Bonesetting Combine Modern Instruments Reduction Techniques for Femoral Fractures

目的：探讨平乐正骨手法结合现代器械复位技术治疗股骨骨折的复位技巧及临床疗效。方法：回顾分析2009年10月-2012年12月收治的股骨骨折患者64例：男39例,女25例;年龄26-62岁,平均39.2岁。按照AO分型：A1型13例,A2型9例,A3型7例,B1型17例,B2型10例,B3型5例,C型3例。采用平乐正骨手法结合撬拨、压顶、钳夹等现代器械复位技术,复位后均行经皮锁定钢板内固定治疗。术后1、3、6、12月及每年随访1次,通过临床影像学、Klemm功能恢复分级标准及膝关节功能Lysholm评分标准评估骨折愈合情况及临床疗效。结果：57例（89.1%）患者术后获得随访,随访时间12-36个月,平均为26.9个月,7例（10.9%）患者失访。术后疗效按照Klemm功能恢复分级标准：优19例,良29例,中9例,优良率为84.2%;按照膝关节功能Lysholm评分标准：优21例,良30例,中6例,优良率为89.5%.结论：平乐正骨手法结合现代器械复位技术治疗股骨骨折,具有复位效果确切、手术时间缩短、操作简单实用、骨折愈合率高等优点,有良好的临床应用价值。

Objective：To investigate the clinical efficacy of Pingle bonesetting techniques combine modern instruments reduction for femoral fractures.Methods：64cases（39males and 25females）femoral fracture patients from October 2009 to December 2012 in our center were retrospectively reviewed,with a average age of 39.2years（range from 26 to 62years）.According to AO classification,there were 13 cases of A1,9cases of A2,7cases of A3,17 cases of B1,10 cases of B2,5cases of B3,3cases of C.All patients were treated with Pingle bonesetting techniques combineed with modern instruments reduction（such as poking,top pressure,clamping,etc.）.And then underwent percutaneous locking plate fixation after reduction.All patients were followed up in the 1,3,6,12 months after surgery.Clinical imaging,Klemm functional recovery grading and Lysholm knee function score system were used to evaluate fracture healing and clinical efficacy.Results：57patients（89.1%）were followed up for 12-36months,with an average of 26.9months,seven cases（10.9%）were lost to follow-up.According to Klemm functional recovery grading criteria,they were excellent in 19 cases,good in 29 cases,fair in 9cases,with a good rate of 84.2%;According to Lysholm knee function score system,they were excellent in 21 cases,good in 30 cases,fair in 6cases,the good rate is 89.5%.Conclusion：Pingle bonesetting techniques combine modern instruments reduction for femoral fractures have a good clinical value for exact effect of reduction,shorter operative time,practical operation and high rate of fracture healing.