股骨远端A及C型骨折给予锁定加压钢板对比逆行髓内钉的临床研究

Clinical Comparative Research on Locking Compression Plate and Retro-grade Intramedullary Nail in Treatment of Type A and Type C Distal Femoral Fractures

目的评析股骨远端A及C型骨折给予锁定加压钢板对比逆行髓内钉治疗的临床效果。方法现从该院2013年7月—2014年7月诊疗的股骨远端A及C型骨折患者筛方便选出68例为观察对象,参照入院就诊顺序号将其分为对照组与研究组,每组34例,两组分别给予锁定加压钢板、逆行髓内钉内固定术治疗,术毕统计两组手术耗时、术中失血量,随访12个月,统计完全负重时间、骨折愈合时间,评估膝关节功能恢复情况及术后并发症。结果研究组的手术耗时、术中失血量、完全负重时间与对照组相比明显更短(P<0.05),而两组在骨折愈合时间上则差异无统计学意义(P>0.05);研究组患者的膝关节功能恢复优良率为91.2%,与对照组的64.7%相较下明显更高(P<0.05);对照组的并发症率为5.9%,与研究组的2.9%相比差异无统计学意义(P>0.05)。结论针对股骨远端A及C型骨折给予锁定加压钢板对比逆行髓内钉这两内固定方式疗效均可,但后者医源性破坏小、有助于早期康复锻炼。

Objective To evaluate and analyze the clinical effect of locking compression plate and retrograde intramedullary nail in treatment of type A and type C distal femoral fractures. Methods 68 cases of patients with type A and type C distal femoral fractures diagnosed and treated in our hospital from July 2013 to July 2014 were selected as the observation object and divided into two groups with 34 cases in each according to the admission order, the control group were treated with locking compression plate, the research group were treated with retrograde intramedullary nailing fixation, the operation time-consumption and intraoperative blood loss were counted after operation, the full weight-bearing time and healing time of fracture were counted, and the recovery of knee joint function and postoperative complications were evaluated. Results The operative time-consumption, intraoperative blood loss and full weight-bearing time in the research group were obviously shorter than those in the control group, P〈0.05, there was no obvious difference in the healing time of fracture between the two groups, P〉0.05, the excellent and good rate of knee joint function in the research group was obviously higher than that in the control group,（91.2% vs 64.7%）, P〈0.05, there was no obvious difference in the complication rate between the control group and the research group,（5.9% vs 2.9%）, P〉0.05. Conclusion Both locking compression plate and retrograde intramedullary nail in treatment of type A and type C distal femoral fractures have a good curative effect, but the Iatrogenic destruction of the latter is small and it contributes to the early rehabilitation exercise.