股骨髁上髓内钉治疗股骨远端C型骨折.docVIP

股骨髁上髓内钉治疗股骨远端C型骨折[摘要] 目的：探讨股骨髁上髓内钉逆行固定治疗股骨远端C型骨折的手术方法及疗效分析。方法：2005年2月～2007年7月，我院应用股骨髁上髓内钉逆行固定治疗19例股骨远端C型骨折，对其疗效进行观察及随访。结果：随访时间6～30个月，平均18个月。19例中，优11例，良5例，可2例，差1例，优良率为84.2%。结论：股骨髁上髓内钉逆行固定其内固定坚强，软组织剥离少，骨折愈合率高，可早期进行功能锻炼，是股骨远端C型骨折理想的内固定方法。 [关键词] 髁上髓内钉；股骨远端；内固定；骨折 [中图分类号] R683.42[文献标识码]A [文章编号]1673-7210（2009）05（b）-036-02 Surgical treatment of distal femoral type C fractures with retrograde intramedullary nail ZHANG Guofu, LU Erhai, GUO Zhirong, ZHAO Shanming, ZHANG Jianrong (The People’s Hospital of Xinhui District, Jiangmen City of Guangdong Province, Jiangmen 529100, China) [Abstract] Objective: To explore the methods and efficacy of the retrograde intramedullary nail for distal femoral type C fractures. Methods: 19 patients with distal femoral type C fractures were treated with retrograde intramedullary nail from February 2005 to July 2007 in our hospital, and the therapeutic effect and follow-up were performed. Results: The follow-up time was 6-30 months, with an average of 18 months. Among 19 cases, 11 cases showed excellent therapeutic effect, 5 cases showed good excellent therapeutic effect, 2 cases showed fair excellent therapeutic effect, 1 case showed poor therapeutic effect, the excellent and good rate was 84.2%. Conclusion: The fixation of retrograde intramedullary nail is strong, soft tissue dissection is less, and the healing rate of fracture is high, and early exercise could be realized. It is an ideal method to treat distal femoral type C fracture with retrograde intramedullary nail. [Key words] Retrograde intramedullary nail; Distal femur; Internal fixation; Fracture 股骨髁上髓内钉是针对髁上骨折和髁间骨折而特别设计的逆行髓内钉，具有中心性固定、内固定坚强、操作简便、软组织剥离少、骨折愈合率高、可早期功能锻炼的优点。笔者采用髁间骨折先行复位固定后，再应用股骨髁上髓内钉逆行插入固定的方法治疗AO分类C型股骨远端骨折，取得令人满意的效果，现报道如下： 1 资料与方法 1.1 一般资料 本组19例，男15例，女4例；年龄18～59岁，平均39岁。其中，开放性骨折7例，闭合性骨折12例；新鲜骨折14例，陈旧性骨折5例；合并其他脏器损伤4例，合并骨盆骨折2例，腰椎骨折2例，股骨干骨折2例，髌骨骨折6例，胫腓骨骨折4例，前臂骨折2例。骨折类型（按AO分型）：C1型9例，C2型6例，C3型4例。致伤原因：车祸伤15例，坠落伤4例。 1.2 治疗方法 本组14例新鲜骨折均在伤后4～