改良前内侧支撑钢板联合外侧锁定钢板固定治疗股骨远端骨折

Modified anteromedial support plate combined with lateral locking plate fixation for the treatment of distal femoral fractures

目的探讨改良前内侧支撑钢板联合外侧锁定钢板固定治疗股骨远端骨折的疗效。方法将46例股骨远端骨折患者按照内固定方式不同分为对照组(采用单纯外侧锁定钢板固定治疗,28例)和观察组(采用改良前内侧支撑钢板联合外侧锁定钢板固定治疗,18例)。比较两组术中出血量、手术时间、骨折愈合时间、膝关节屈曲活动度。结果患者均获得随访,时间5~16个月。术中出血量两组比较差异无统计学意义(P>0.05);手术时间对照组短于观察组(P<0.01)。骨折愈合时间、术后5个月膝关节屈曲活动度观察组短(大)于对照组(P<0.01)。结论改良前内侧支撑钢板联合外侧锁定钢板固定治疗股骨远端骨折,可充分显露骨折断端,复位及固定效果可靠,具有缩短骨折愈合时间、利于患者早期进行膝关节功能锻炼的优势,但存在手术时间长的不足。

Objective To investigate the efficacy of modified anteromedial support plate combined with lateral locking plate fixation in the treatment of distal femoral fractures.Methods The 46 patients with distal femoral fractures were divided into a control group(28 cases were treated with simple lateral lockingplate fixation)and an observation group(18 cases were treated with modified anteromedial support plate combined with lateral locking plate fixation),according to different internal fixation methods.The intraoperative bleeding volume,surgical time,fracture healing time,and knee flexion range of motion were compared between two groups.Results All patients were followed up for 5~16 months.There was no statistical significance in intraoperative bleeding between the two groups(P>0.05);the surgical time in the control group was shorter than that in the observation group(P<0.01);the fracture healing time and knee joint flexion range of motion at 5 months after surgery were shorter(larger)in the observation group,compared with the control group(P<0.01).Conclusions The combination of modified anteromedial support plate and lateral locking plate fixation for the treatment of distal femoral fractures can fully expose the fracture end,with reliable reduction and fixation effects.It has the advantages of shortening fracture healing time and facilitating early knee joint exercise for patients,but there is also shortcoming of prolonging surgical time.