两种微创手术治疗股骨远端骨折的临床对比研究

Clinical comparison of two minimally invasive techniques in treatment of distal femur fractures

目的探讨锁定接骨板和髓内钉内固定微创治疗股骨远端骨折的临床疗效。方法我院自2012-06~2015-01收治53例股骨远端骨折患者,分为逆行髓内钉内固定微创治疗组(髓内钉组)和锁定接骨板内固定微创治疗组(MIPPO组),对骨折治疗过程、愈合情况、功能进行评估。结果所有患者得到有效随访,时间为12~24月。髓内钉组患者骨折临床愈合时间为12.1±6.4周,MIPPO组患者骨折临床愈合时间为12.5±5.7周。术中出血量,髓内钉组优于MIPPO组,透视次数MIPPO组优于髓内钉组(P<0.05);两组手术时间、最后的膝关节功能评分、并发症均无统计学差异(P>0.05)。结论髓内钉固定和MIPPO技术是治疗股骨远端骨折两种有效的治疗方法,医生应根据患者、科室具体条件及自身熟练情况选用。

Objective To compare intramedullary nailing（ IMN） versus minimally invasive plate osteosynthesis（ MIPPO） for the treatment of distal femur fractures. Methods From May 2012 to January 2015,53 patients with distal femoral fractures were divided into retinal intramedullary nail fixation minimally invasive group（ intramedullary nail group） and locking plate fixation minimally invasive treatment group（ MIPPO group）. The fracture treatment process,healing,function evaluation. Results All patients were followed up for a period of 12 ~ 24 months. The clinical healing time of fractures was 12. 1 ± 6. 4 weeks in patients with intramedullary nail group and 12. 5 ± 5. 7 weeks in MIPPO group. For intraoperative blood loss,intramedullary nail group was superior to MIPPO group,and for the number of fluoroscopes,MIPPO group was superior to intramedullary nail group（ P 〈0. 05）. There was no significant difference between the two groups in operation time,the final knee function score and the complication（ P 〉0. 05）. Conclusion Intramedullary nail fixation and MIPPO technique are two effective treatments for the treatment of distal femoral fractures. Physicians should choose according to the specific conditions of patients and departments and their own proficiency.