微创稳定系统治疗股骨远端、胫骨近端骨折的疗效及术中相关因素

Curative effect and intraoperative related factors of less invasive stabilization systems in the treatment of distal femur,proximal tibia fractures

目的:探讨采用微创稳定系统(LISS)治疗股骨远端及胫骨近端骨折的疗效,并分析术中相关因素。方法:2009年1月-2013年1月收治骨折患者48例,将其随机分为观察组(25例)和对照组(23例),观察组采用股骨远端或胫骨近端LISS,对照组行解剖钢板内固治疗。所有患者术前及术后进行X线片检查,术后对其伤口愈合及关节功能恢复情况进行追踪记录。观察分析两组患者手术时间、术中出血量、愈合时间及膝功能恢复情况。结果:观察组手术时间、术中出血量以及愈合时间均明显优于对照组,差异有统计学意义(P<0.01)。治疗后随访12个月,观察组骨折患者的HSS评分(87.2±2.8)分,显著高于对照组(71.3±3.8)分,差异有统计学意义(P<0.05)。结论:LISS钢板设计独特,能有效保护骨膜及其骨折部位的血运,操作简便、术中出血量少,并能促进骨折愈合及膝功能的恢复,减少并发症的发生。但其作为一种全新的内固定器设计理念,医护人员要加强理念理解、了解术中相关因素并熟练掌握术中操作程序。

Objective:To explore the curative effect of using less invasive stabilization systems(LISS) in the treatment of distal femur,proximal tibia fractures,to analyze the intraoperative related factors.Methods:48 patients with fractures were selected from January 2009 to January 2013.They were randomly divided into the observation group(25 cases) and the control group(23 cases).The observation group used distal femur or proximal tibia LISS,the control group was given anatomic plate internal fixation treatment.All patients were given X-ray examination before and after operation.The postoperative wound healing and joint function recovery were record.The operation time,intraoperative bleeding volume,healing time and knee functional recovery of patients in two groups were observed and analyzed.Results:The operation time,intraoperative bleeding volume and healing time of the observation group were significantly better than those of the control group,and the difference was statistically significant(P<0.01).Patients were followed up for 12 months after treatment,HSS score of fracture patients in the observation group was(87.2±2.8)scores,which was significantly higher than that of the control group(71.3 ± 3.8)scores,and the difference was statistically significant(P<0.05).Conclusion:The unique LISS plate design can effectively protect the periosteum and the blood supply of fracture site.It has simple operation and less intraoperatve blood soss,and it can promote the fracture healing and knee functional recovery,and reduce the occurrence of complications.But it is a new internal fixation device design concept,the medical care personnel must strengthen the concept understanding,understand the intraoperative related factors and master the intraoperative operation procedure.