老年股骨髁部骨折的治疗分析

Treatment of femoral condyle fracture in aged patients

目的探讨治疗老年股骨髁部骨折的内固定器选择及应用要点。方法治疗82例老年股骨髁部骨折,A型26例,B型17例,C型39例。分别采用95°角翼钢板(19例)、T型钢板(5例)、AO股骨髁支持钢板(11例)、动力髁螺钉(dynamiccondylarscrew,DCS)(23例)、股骨髁上带锁髓内钉(greenseligsenhenry,GSH)(24例)进行治疗,共28例采用自体髂骨或同种异体骨植骨。结果经平均14.6个月随访,按Merchan等评分标准评定膝关节功能,总优良率为90.2%。结论老年股骨髁部骨折具有特殊性,针对骨折类型选择内固定器是治疗的重要环节。手术的关键在于保持股骨髁关节面的完整性和牢固固定。

Objective To discuss the selection and application of internal fixators in the treatment of aged patients suffering from femoral condyle fracture. Methods 82 aged patients with femoral condyle fracture were treated from February 1995 to June 2002. According to AO/ASIF classifcation,26 cases were classified as type A,17 cases type B, and 39 cases type C. They were treated with internal fixation by 95°angle plate (19 cases), T type plate(5 cases), AO condyle supporting plate (11 cases), dynamic condylar screw (DCS) (23 cases) and Green Seligsen Henry (GSH) (24 cases). Measures of auto ilium transplant or homologous allograft bone transplant (28 cases) were also taken. Results All the cases were followed up for an average of 14.6 months. Merchan grading method was applied to evaluate their knee joint functions. The total excellent and good rate was 90.2%. Conclusions Aged patients with femoral condyle fracture should be treated specially. The fixation should be chosen according to their fracture type so as to ensure fine clinical results. The goal of the operation is to keep the integrity of articular surface of the femoral condyle and to acquire secure internal fixation.