单、双钢板与髓内钉三种内固定方法在股骨远端内侧粉碎性骨折患者中的应用

Application of Three Internal Fixation Methods (Single. Double Steel Plate and Intramedullary Nailing) in Patients with Comminuted Distal Medial Femur Fractures

【目的】比较单、双钢板与髓内钉三种内固定方法在股骨远端内侧粉碎性骨折患者中的应用效果。【方法】选择本院2013年1月至2017年12月收治的股骨远端内侧粉碎性骨折患者82例作为研究对象,根据内固定材料分为单钢板组27例、双钢板组34例、髓内钉组21例。术后即刻、末次随访X线摄片检查股骨角,观察股骨角变化量;记录各组患者手术时间、术中出血量、骨折愈合时间和骨折愈合情况。【结果】双钢板组平均手术时间、平均出血量明显高于单钢板组和髓内钉组,差异有统计学意义(P <0.05) 0单钢板组畸形愈合率显著高于双钢板组和髓内钉组,差异有统计学意义(P <0.05);各组骨折愈合时间差异无统计学意义(P >0.05);术后与末次随访,单钢板组术后股骨角差值明显高于双钢板组和髓内钉组,双钢板组明显高于髓内钉组,差异有统计学意义(P <0.05) 0【结论】从手术创伤和维持复位能力综合评价,三种内固定方法治疗股骨远端内侧粉碎性骨折的疗效依次为髓内钉、双钢板、单钢板固定,但除外累及关节面者。

[Objcctivc]To compare the application effect of three internal fixation methods in patients with comminuted distal medial femoral fracturei single steel plate, double steel plate and intramedullary nail.[Methods] A total of 82 patients with distal medial comminuted femoral fractures in our hospital from January 2013 to December 2017 were selected as the research subjects. According to the internal fixation materials, patients were divided into the single steel plate group (27 cases), the double steel plate group (34 cases), and the intramedullary nailing group (21 cases)., The femur angle variation were compared by the X-ray radiography examination of femoral angle at immediately after surgery and the last follow up. The operation lime, intraoperative blood loss, fracture healing status and time were recorded.(Results! The average operation time and the average blood loss in the double plate group were significantly higher than those in the single-plate group and the intramedullary nail group, with statistically significant differences ( P <0.05). The rate of malformation in the single plate group was significantly higher tlitn that in the double plate group and the intramedullary nail group, and the difference was statistically significant ( P <0.05). There were no significant differences in fracture healing time among groups ( P >0.05). X-ray radiography examinations of femoral angle at immediately after surgery and the last follow-up showed that the difference of femoral angle changes in single plate group was significantly higher than that in double piste group and the intramedullary nail group, and the double plate group was significantly higher than that in the intramedullary nailing group. The differences were statistically significant ( P <0.05).[Conclusion]According to the comprehensive evaluation of surgical trauma and reduction ability maintenance, the therapeutic effect of the three types of internal fixation for the treatment of comminuted fracture of the distal femur were followed by intramedullary nail, double plate and single plate, except for those involving the articular surface.