股骨远端解剖钢板的设计与临床应用

The Design and Clinic Application of Anatomical Plate in Distal Femur Fracture

目的 分析股骨远端解剖钢板的应用效果。方法 采用自行设计的股骨远端半环式解剖钢板治疗股骨远端各类型骨折38例。结果 38例中 35例获 6～ 36个月的有效随访 ,30例骨折对位良好 ,钢板固定确实 ,膝关节伸屈功能≥ 90°,达到优良标准 ;3例骨折愈合 ,但关节仅有 1 5°～ 2 0°伸屈范围 ,经二次粘连松解手术后达到≥ 70°评为中 ;2例为差 ,一例骨不连作二次植骨愈合 ,一例关节强直作了人工膝关节置换。结论 以股骨远端为模板所设制的解剖钢板 ,具有良好的生物力学分布 ,克服了现有钢板偏心型固定所带来的缺点 ;其良好的复位 ,确实内固定效果 。

Objective To analyze applicative effect of anatomical plate in distal femur fracture.Methods Thirty eigth cases of diversified types distal femur fracture were treated by adopt semi circular anatomical plate that was designed.Results Thirty five cases were effectual follow up 6～36 months in 38 cases.Fine criterion,which contraposition of fracture were good,internal fixation of anatomical plate were assuredness and movement degree of knee joint were more than 90°,were achieved in 30 cases.Moderate criterion,which the fracture were healed up and movement degree of knee joint only were15°～20°but movement degree of knee joint were more than70°after the second operation,were evaluated in 3 cases.Two cases evaluation were worse.One case of bone nonunion was healed up after the second operation and knee replacement were operated in one anchylosis case.Conclusion According to template of femoral distal,anatomical plate,which there were well distributing in biomechanics and overcame disadvantage of eccentricity being brought existent internal fixation,were designed and made.The effect of diaplasis and fixation were attained well,and it may be valuably farther popularized and used in clinic.