股骨远端解剖型钢板加长螺钉治疗股骨下端骨折的临床效果分析

Clinical effects analysis of distal femoral anatomic plate together with long screw in treating distal femoral fracture

目的探讨应用股骨远端解剖型钢板加长螺钉治疗股骨下端骨折的临床效果。方法选取2013年7月~2015年6月在广州市花都区第二人民医院治疗的股骨下端骨折患者76例,随机分为观察组与对照组,各38例,观察组接受股骨远端解剖型钢板加长螺钉内固定术,对照组使用锁定钢板内固定术治疗,比较两组的术中出血量、骨折愈合时间、手术时间、术后住院时间、膝关节功能评分及并发症发生率。结果两组患者经术后随访全部骨性愈合,观察组的术中出血量(286.55±18.74)ml,低于对照组的(416.45±19.35)ml,差异有统计学意义(t=26.78,P<0.01);骨折愈合时间(138.56±18.06)d,优于对照组的(185.24±28.26)d,差异有统计学意义(t=18.64,P<0.01)。观察组术后24 h和48 h的VAS疼痛评分分别为(5.68±1.24)分与(3.56±0.85)分,低于对照组的(6.96±1.13)分与(4.96±1.12)分,差异均有统计学意义(P<0.05)。两组手术时间和术后住院时间比较,差异均无统计学意义(P>0.05)。观察组术后并发症总发生率为5.26%,低于对照组的21.05%,差异有统计学意义(χ2=4.15,P<0.05)。观察组膝关节功能评分优良率为92.11%,高于对照组的68.42%,差异有统计学意义(χ2=6.73,P<0.05)。结论股骨远端解剖型钢板加长螺钉内固定是治疗股骨下端骨折的有效方法,可以临床推广应用。

Objective To explore the clinical effects of distal femoral anatomic plate together with long screw in treating distal femoral fracture.Methods A total of 76 cases with distal femoral fracture from July 2013 to June 2015 in Guangzhou municipal Huadu district the 2ndPeople′ s Hospital were selected and randomly divided into observation group and control group,38 cases in each groups.The observation group was accepted the treatment of distal femoral anatomic plate with long screw internal fixation,and the control group was treated by locking plate internal fixation.The intraoperative blood loss,bony healing time,operative time,postoperative time of hospitalization,knee joint function scoreandcomplication between two groups were compared.Results All patients were got bony healing after treatment.The intraoperative blood loss of observation group was（286.55±18.74） ml lower than that of control group of（416.45±19.35）ml,with significant difference（t=26.78,P〈0.01）,and bony healing time of observation group was（138.56±18.06） d,was better than that of control group of（185.24±28.26） d（t=18.64,P〈0.01）.The VAS pain scores of observation group at 24 and 48 hours after surgery respectively were（5.68±1.24） scores and（3.56±0.85） scores were lower than those of control group of（6.96±1.13）scores and（4.96±1.12） scores,with differences were significant（P〈0.05）.The operative time and postoperative time of hospitalization between two groups were no significant differences（P〈0.05）.The total postoperative complication of observation group was 5.26% lower than that of control group of 21.05%（χ2=4.15,P〈0.05）,and the excellent rate of knee joint function score of observation group was 92.11%,higher than that of control group of 68.42%（χ2=6.73,P〈0.05）.Conclusion The distal femoral anatomic plate with long screw internal fixation is effective for treating distal femoral fracture,and can be clinically promoted.