两种不同锁定系统治疗股骨髁间C3型骨折

Two different locking systems for treatment of type C3 femoral intercondylar fractures

目的比较桥接组合式内固定系统与锁定加压钢板治疗股骨髁间C3型骨折的临床效果。方法将56例股骨髁间C3型骨折患者按内固定方式不同分为桥接组(采用桥接组合式内固定系统,30例)和锁定钢板组(采用锁定加压钢板,26例)。记录手术时间、术中出血量、骨折愈合时间、并发症情况,按Merchan评分标准行膝关节评分。结果患者均获得随访,时间10～36个月。手术时间、术中出血量、膝关节功能评分两组比较差异均无统计学意义(P> 0. 05)。骨折愈合时间、骨不连发生率桥接组短(低)于锁定钢板组,差异均有统计学意义(P <0. 05)。结论桥接组合式内固定系统治疗股骨髁间C3型骨折,固定效果与锁定加压钢板相似,但手术复位方便,固定稳妥,对骨折断端血供破坏少,骨折愈合快。

Objective To compare the clinical effect of bridge combined internal fixation system and locking compression plate for the treatment of type C3 in the femoral intercondylar fracture.Methods The 56 patients with type C3 in the femoral intercondylar fracture were divided into the bridging group(30 cases with the bridge-combined internal fixation system)and the locking plate group(26 cases with the locking compression plate group)according to different internal fixation methods.The operation time,intraoperative blood loss,fracture healing time and related complications were recorded.Knee functions were evaluated according to Merchan scoring criteria.Results All patients were followed up for 10~36 months.There was no statistically significant difference between the two groups in operation time,intraoperative blood loss and knee function score(P>0.05).The fracture healing time of the bridging group was shorter than that of the locking plate group,and the incidence rate of bone nonunion was lower than that of the locking plate group,and the difference was statistically significant(P<0.05).Conclusions Bridge combined internal fixation system provide a similar fixation compared with locking compression plate,but achieve easier reduction,less blood supply destruction and faster bone healing for the treatment of type C3 in the femoral intercondylar fracture.