逆行交锁髓内钉与股骨远端锁定钢板内固定治疗老年股骨髁上骨折的疗效比较

Comparison of retrograde interlocking intramedullary nail and distal femoral locking plate fixation in the treatment of elderly patients with femoral condylar fracture

目的比较分析逆行交锁髓内钉与股骨远端锁定钢板内固定治疗老年股骨髁上骨折的临床疗效。方法选取我院骨科2014年1～12月间收治的老年股骨髁上骨折患者40例作为研究对象，将其随机分为两组。分别设为A组、B组．且每组均为20例，A组患者采用逆行交锁髓内钉内固定治疗．B组患者采用股骨远端锁定钢板内固定治疗，分别对两组患者的切口长度、手术时间、术中出血量等指标进行比较，随访后观察两组患者的膝关节功能恢复效果。结果A组和B组患者的手术切口长度分别为（9．8±1．1）cm、（17．9±1．6）cm，术中出血量分别为（395．9±68．3）mL、（568．2±93．4）mL，A组显著优于B组，而其手术时间分别为（85．2±12．5）min、（73．1±11．4）min，B组显著优于A组，差异有统计学意义（P〈O．05）。经随访，A组和B组患者的膝关节恢复优良率分别为95．0％和90．0％，差异无统计学意义（P〉0．05）。结论通过逆行交锁髓内钉和股骨远端锁定钢板内固定治疗老年股骨髁上骨折均能获得比较理想的治疗效果，有利于患者的膝关节功能恢复，二者各有优缺点，可在具体治疗过程中根据患者的实际情况选择合适的治疗方法。

Objective Tc compare the clinical effect of retrograde interlocking intramedullary nail and distal locking plate fixation in the trealment of femoral condyle fracture in the elderly. Methods A total of 40 elderly patients with femoral condyle fracture iin our hospital of orthopedics department were selected as the research object from January to December 2014, which were randomly divided into group A, group B, each group of 20 cases. Patients in group A were treated with retrograde interlocking intramedullary nailing,patients in group B were treated with distal femoral locking plate internal fixation. The incision length, operative time, bleeding volume, functional recovery of knee joint were compared between the two groups. Results Group A and group B patients＇s incision length were （9.8±1.1） cm, （17.9± 1.6）cm, intraoperative bleeding were （395.9±68.3） mL, （568.2±93.4） mL, group A was better than that in group B, and the operation time was（85.2±12.5） min, （73.1±11.4）min, group B was better than that in group A, with a significant dif- ference between two grouls （P〈O.05）. After follow-up, the excellent rate of knee recovery in patients with group A and group B were 95.0% and 90.0%, there was no significant difference （P〉0.05）. Conclusion Using the retrograde cross lock intramedullary nail and distal femoral locking plate internal fixation in the treatment of elderly femoral supra- condylar fracture can achieve ideal treatment effect, is beneficial to the recovery of knee joint function of patients, and each of them has its＇s advantages and disadvantages, according to the actual situation of the specific treatment process, select the appropriate treatment method.