逆行交锁髓内钉治疗股骨远端骨折疗效观察

Effects of retrograde intramedullary interlocking nails treating distal femoral fractures

目的探讨应用逆行交锁髓内钉治疗股骨远端 (髁上及髁间 )骨折治疗效果。方法我院自 1996年 8月 - 2 0 0 3年 6月对 2 4例股骨远端骨折按AO分类 :A2 型 3例 ,A3 型 4例 ,B1型 5例 ,B2 型 2例 ,C1型 5例 ,C2 型 4例 ,C3 型 1例。均采用逆行带锁髓内钉治疗。结果经随访 8月 - 2年 ,平均 12个月 ;骨折愈合时间为 8- 16周 ,平均 13周。根据Neer膝关节功能评分标准 ,优 14例 ,良 7例 ,可 3例 ,优良率为 87.5 %。结论逆行带锁髓内钉是治疗股骨远端骨折的一种理想方法 ,由于其固定可靠 ,可早期功能锻炼 ,骨折愈合快 ,能最大限度恢复膝关节功能。

Objective To study the effects of retrograde intramedullary interlocking nails treating distal femoral fractures and assess the outcome of the corresponding treatment. Methods From August 1996 to June 2003, 24 patients (19 males and 5 females) with distal femoral fractures were treated in our department with retrograde femoral nailing. According to the AO/ASIF-classification we classified 7 fractures as supracondylar A fractures, 7 fractures as dia-condylar B fractures and 10 fractures as intercondylar C fractures.Results All fractures were followed up for 8 months to 2 years (mean 12 months). Solid union was documented in all patients at 13 weeks on average. Using the Neer scoring system, there were 14 excellent, 7 good, and 3 fair results; none of the cases were considered as failures.The knee function score was 87.5 % on average. Conclusions Retrograde intramedullary nail is an effective alternative for treatment of distal femoral fractures because it can provide a stable and reliable fixation which is beneficial for early functional exercise of knee.