动力髁螺钉(DCS)治疗股骨髁上骨不连16例报告

Treatment of femoral supracondylar nonunion by dynamic condylar screw (DCS): a nalysis of 16 cases

目的观察动力髁螺钉(DCS)治疗股骨髁上骨不连的临床疗效。方法16例股骨髁上骨不连均采用断端修整、自体髂骨植骨及DCS内固定治疗,5例伴有膝关节粘连者同时行膝关节松解术。结果所有病例获得随访,时间12～48个月,平均18个月。在4～9个月内均获骨性愈合。合并膝关节粘连者功能也获得明显改善。参照Shelbourne疗效评定标准,优8例,良5例,功能优良率达81.3%。结论应用DCS固定+自体髂骨植骨后,骨折端可获得坚强内固定及持久的压应力,有利于早期进行膝关节功能锻炼,是治疗股骨髁上骨不连的有效方法。

Objective To discuss the effects of DCS in treatment of femoral su pracondylar fracture nonunion. Methods 16 patients with supracondylar femoral fr acture nonunion were treated with iliac bone autograft and DCS internal fixation . Arthrolysis was performed simultaneously in 5 cases with knee synarthrophysis. Results All cases were followed up for 12 to 48 months(averaging 18 months). Bone union was achieved in all the cases within 4 to 9 months. Knee functions of 5 cases with ankylosis improved. According to Sheobourae criteria, there were 8 excellent cases and 5 good, with the excellent and good rate being 81.3%. Conc lusion DCS and iliac bone autograft is an effective method for treatment of femo ral supracondylar fracture nonunion, for it can provide firm internal fixation a nd constant compressive stress, and allow immediate active movement.