股骨髁上骨折两种内固定方式的疗效分析

Analysis of the therapeutic effect of DCS and DFN on supracondylar fracture of femur

目的 探讨股骨髁上骨折两种内固定的手术适应证和手术方式选择。方法 随机选取 40例患者 ,给予股骨髁滑动加压钉 板内固定术 (DCS) 2 0例和股骨远端逆行交锁髓内钉内固定术 (DFN) 2 0例 ,记录两组术前、术中、术后的多项相关指标并予以统计学分析。结果 所有患者均随访 12～ 2 8个月至骨折愈合后 ,平均 16个月 ;DFN组与DCS组相比 ,手术时间、切口长度、术中失血量、总输血量、术后引流量、术后骨折愈合时间及膝内翻均表现出明显的统计学差异。结论 DFN较适合于股骨髁的解剖和生物力学特点 ,固定牢靠、手术损伤较小 ,手术时间短 ,骨折并发症少 ,较有利同期处理多发伤 ,尤其适用于A1。

Objective To investigate the operative indications and operative ways of supracondylar fracture of femur.Methods 40 patients with supracondylar fracture of femur were randomly divided into two groups.20 patients were treated by dynamic condylar screw (DCS);the other 20 patients were treated by distal femoral nail (DFN).The relative indexes of preoperative,intraoperative,postoperative condition were observed and analyzed statistically.Results All the cases were followed up for 12～28 months until fractures healed up,and mean healing time was 18 months.There were significant differences in the incision length,operation time,intraoperative blood loss,total volume of blood transfusion,postoperative drainage,fracture healing time and complication between DFN group and DCS group.Conclusion DFN is more suitable for the biomechanical and anatomical characteristics of supracondylar of femur,with remarkable therapeutic effect,less operative injury and postoperative complications,which is more beneficial to cope with other associated injuries at the same time,especially for type A1 and type A3 supracondylar fracture of femur.