髌外侧入路与股骨前外侧入路联合LISS钢板治疗C型股骨远端骨折的疗效及安全性分析

Curative Effect and Safety of Patellar Lateral Approach and Femoral Anterolateral Approach Combined with LISS Plate in Treatment of Patients with Type C Distal Femoral Fractures

目的比较髌外侧入路与股骨前外侧入路联合LISS钢板治疗C型股骨远端骨折的疗效及安全性。方法选取2013年6月—2016年6月我院诊治的C型股骨远端骨折患者100例,按照手术入路不同分为A组41例和B组59例。A组采用髌外侧入路联合LISS钢板治疗,B组采用股骨前外侧入路联合LISS钢板治疗。比较2组手术情况、住院时间、骨折愈合时间和术后3、6、12个月膝关节功能恢复情况,记录手术优良率及术后并发症发生率。结果 2组术中出血量、住院时间及骨折愈合时间比较差异无统计学意义(P>0.05);A组手术时间短于B组(P<0.05),A组术后3、6、12个月美国特种外科医院膝关节评分、手术优良率高于B组(P<0.05)。2组术后并发症发生率比较差异无统计学意义(P>0.05)。结论与股骨前外侧入路联合LISS钢板治疗C型股骨远端骨折相比,髌外侧入路联合LISS钢板治疗该类骨折效果更好,手术时间短,软组织损伤小,有利于术后膝关节功能的恢复,安全性较高。

Objective To compare curative effect and safety of patellar lateral approach and femoral anterolateral approach combined with minimally invasive internal fixation system (LISS) plate in treatment of patients with type C distal femoral fractures. Methods A total of 100 patients with type C distal femoral fracture admitted during June 2013 and June 2016 were divided into group A ( n =41) and group B ( n =59) according to different surgical approaches. Group A was treated with patellar lateral approach combined with LISS plate, while group B was treated with femoral anterolateral approach combined with LISS plate. In two groups, operative condition, length of hospital stay, fracture healing time and function conditions of knee joint in the 3 rd , 6 th and 12 th months after operation were compared, and excellent and good rates of operation and the incidence rates of postoperative complications were recorded. Results There were no significant differences in intraoperative bleeding volume, length of hospital stay or fracture healing time between two groups ( P > 0.05). In group A, operative time was significantly shorter ( P <0.05);knee joint scores of America Special surgical hospital in the 3 rd , 6 th and 12 th months after operation and excellent rate of operation were significantly higher than those in group B ( P <0.05). There was no significant difference in incidence rate of postoperative complications between two groups ( P >0.05). Conclusion Compared with those by femoral anterolateral approach combined with LISS plate, patellar lateral approach combined with LISS plate may achieve better curative effect, shorter operative time and less soft tissue injury, and it is beneficial to postoperative recovery of knee function with good safety.