内外侧双钢板内固定治疗股骨远端C型骨折

Internal Fixation of Double Internal and External Plates for Type C Fractures of Distal Femur

目的探讨内外侧双钢板内固定治疗股骨远端C型骨折的临床疗效。方法我院2017年1月~2018年12月共收治股骨远端C型骨折患者7例,其中左侧5例,右侧2例;按AO分型,C1型1例,C2型2例,C3型4例。均行内外侧入路切开复位双钢板内固定术,外侧选择股骨远端外侧解剖锁定钢板,内侧选择直行锁定重建钢板。结果本组7例患者伤口均一期愈合。均获随访,平均随访时间17.2(14~24)个月。均获骨性愈合,平均骨折愈合时间7.8(4~12)个月。膝关节功能采用美国特种外科医院(Hospital for Special Surgery,HSS)评分标准进行评估,平均为82.7(67~100)分。1例评分低于80分,末次随访时出现创伤性关节炎,该例患者膝关节活动部分受限,长距离行走或天气变化时有膝关节疼痛。结论应用内外侧双钢板治疗股骨远端C型骨折临床疗效满意。

Objective To explore the clinical effect of Orthopaeclic double internal and external plates for type C fractures of distal femur.Methods A total of 7 cases with type C fractures of distal femur were treated by open reduction and internal fixation of double internal and external plates from January 2017 to December 2018 in our hospital,including 5 of left lateral and 2 of right lateral.According to AO classification,there were 1 case of type C1,2 cases of type C2 and 4 cases of type C3.For the internal fixation,the lateral anatomical locking plate of distal femur was selected for the lateral side,and the straight locking reconstruction plate was selected for the medial side.Results All 7 cases achieved primary wounds healing.They were followed up for 17.2 months averagely(ranged from 14 to 24 months),and all achieved bone union during 4 to 12 months(average 7.8 months).According to knee function scoring standard of HSS,the mean score was 82.7(ranged from 67~100).The score of one case was lower than 80,and traumatic arthritis occurred at the last follow-up.The patient's knee joint activity was partially limited,and he had knee joint pain when walking for a long distance or when the weather changed.Conclusion The internal fixation of double internal and external plates can achieve reliable effect for type C fractures of distal femur.