新型股骨远端前外侧入路在现代骨科康复观指导下的疗效分析

Analysis on Effect of Distal Femoral Anterolateral Approach under the Guidance of the Modern Rehabilitation Concept in Department of Orthopedics

目的探讨新型股骨远端前外侧入路在现代骨科康复观指导下的疗效。方法选择2011年1月至2014年6月日照市岚山区人民医院骨科收治的62例股骨远端骨折患者为研究对象,依据手术方式不同分为观察组和对照组,各31例。观察组采用新型股骨远端前外侧入路,对照组采用常规股骨远端外侧入路。比较两组患者手术时间、术中出血量、术中透视次数、住院时间、并发症、骨折愈合时间、膝关节功能评分(HSS),检测受试者C反应蛋白(CRP)和肌酸激酶(CK)水平。结果观察组手术时间、术中出血量、术中透视次数均少于对照组[(65±6)min比(81±6)min,(320±10)m L比(420±16)m L,(1.9±1.0)次比(3.4±1.0)次],差异有统计学意义(P<0.01);两组术后各个时间点CRP、CK水平呈上升趋势,且观察组术后各个时间点CK水平均低于同期对照组(P<0.01);两组骨折愈合时间、并发症发生率比较差异无统计学意义(P>0.05),观察组HSS评分高于对照组[(95±6)分比(89±5)分],差异有统计学意义(P<0.01)。结论股骨远端骨折术中采用新型前外侧入路,可以减少对软组织的损害,缩短手术时间,提高手术效果,有效改善患者膝关节功能,且安全性较高。

Objective To study the effect of distal femoral anterolateral approach under the guidance of the modern rehabilitation concept in department of orthopedics. Methods During Jan. 2011 and Jun. 2014,62 distal femoral fractures patients from Department of Orthopedics of Rizhao Lanshan District People＇s Hospital were included as the research objects. Based surgical procedures they were divided into observation group and control group,31 cases in each group. Patients in the observation group adopted a new type of distal femoral anterolateral approach,while patients in the control group adopted conventional distal femoral lateral approach. The operative time,bleeding volume,intraoperative fluoroscopy times,hospitalization time,complications,fracture healing time,knee joint function score（ HSS）,C-reactive protein（ CRP） and creatine kinase（ CK） levels were recorded / tested and compared. Results The operation time,intraoperative blood loss,intraoperative fluoroscopy times of the observation group were less than the control group [（ 65 ± 6） min vs（ 81 ± 6） min,（ 320 ± 10） m L vs（ 420 ± 16） m L,（ 1. 9 ± 1. 0） vs（ 3. 4 ± 1. 0）,P 0. 01]. At different time points after operation in the two groups,the levels of CRP and CK increased,and the CK level of patients in the observation group at each time point was lower than that of the control group（ P 0. 01）; the fracture healing time,complication rate of the two groups had no significant difference（ P 0. 05）,the HSS score of the observation group was higher than the control group [（ 95 ± 6） vs（ 89 ± 5）,P 0. 01].Conclusion The new anterolateral approach for the distal femur fracture surgery,can reduce the soft tissue damage,save operation time,improve the operation effect,and effectively improve the knee joint function of patients with higher safety.