对比锁定钢板和髓内钉治疗股骨下段骨折的临床效果

Clinical Effect of Locking Plate and Intramedullary Nail in the Treatment of Distal Femoral Fracture

目的:观察在股骨下段骨折患者中采取锁定钢板和髓内钉治疗的临床效果。方法:将笔者所在医院骨外科2016年1月-2018年6月收治的以股骨下段骨折为诊断,拟进行手术的患者85例按随机数字法分成A组(43例)与B组(42例)。A组患者采取锁定钢板治疗,B组患者采取髓内钉治疗。对照两组患者住院时间、负重情况、平均骨折愈合时间、并发症情况,以及术后1、6个月ADL评分、骨折术后下肢功能评分。结果:A组患者住院时间、负重时间及骨折愈合时间均低于B组,差异均有统计学意义(P<0.01)。A组发生骨折不愈合1例,固定物移位1例,并发症发生率为4.66%,B组患者发生感染1例,骨折不愈合3例,骨折畸形愈合3例,固定物移位4例,并发症发生率为26.19%,差异有统计学意义(P<0.01)。术后1个月两组患者ADL、下肢功能评分差异无统计学意义(P>0.05),术后6个月A组患者ADL评分高于对照组,下肢功能评分低于对照组,差异均有统计学意义(P<0.001)。结论:在股骨下段骨折患者中,采取锁定钢板治疗较髓内钉治疗方式,可明显缩短住院时间、负重时间与骨折愈合时间,减少术后并发症的发生,在6个月的随访期内,可使患者获得更好的膝功能评分,并可明显改善患者下肢功能,效果理想。

Objective:To observe the clinical effect of locking plate and intramedullary nail in the treatment of distal femoral fracture.Method:A total of 85 patients with distal femoral fracture were treated in our hospital in the recent period(January 2016 to June 2018).They were randomly divided into group A(43 cases) and group B(42 cases).Group A was treated with locking plate and group B with intramedullary nail.The hospitalization time,weight bearing,average fracture healing time and complications of the two groups were compared with ADL scores at 1 month and 6 months after operation and lower limb function scores after fracture operation.Result:The hospital stay,weight bearing time and fracture healing time of group A were significantly less than those of group B,with statistical significance(P<0.01).In group A,1 case had fracture nonunion,1 case had fixation displacement,and the incidence of complications was 4.66%.In group B,1 case had infection,3 cases had fracture nonunion,3 cases had fracture malunion and 4 cases had fixation displacement,the incidence of complications was 26.19%.The difference was statistically significant(P<0.01).There was no significant difference in ADL and lower limb function score between the two groups at 1 month after operation(P>0.05).At 6 months after operation,ADL scores in group A were significantly higher than those in control group,and lower limb function scores were significantly lower than those in control group(P<0.001).Conclusion:Compared with intramedullary nail,locking plate can significantly shorten hospitalization time,weight-bearing time and fracture healing time,reduce the occurrence of postoperative complications in patients with distal femoral fracture.During the follow-up period of 6 months,patients can get better knee function score and significantly improve lower limb function,the effect is ideal.