股骨髁间粉碎性骨折3种内固定临床疗效观察.docVIP

股骨髁间粉碎性骨折3种内固定临床疗效观察 　　[摘要] 目的 探讨3种内固定对股骨髁间粉碎性骨折的临床疗效。方法 选择符合条件的股骨髁间粉碎性骨折患者行手术切开复位后分别采用普通钢板内固定（A组）、髁支持钢板内固定（B组）及动力髁部螺丝内固定（C组），比较3组患者Sanders临床评分及术后并发症发生情况。结果 3组患者Sanders临床评分比较，差异无统计学意义（P0.05）。3组患者并发症以A组多见，但同B组、C组比较，差异无统计学意义（P0.05）。结论 临床上对股骨髁间粉碎性骨折只要遵循切开复位内固定的原则，就有利于患者的关节功能恢复，采用3种内固定的临床效果无差异，对手术质量无明显影响。 　　[关键词] 股骨髁间粉碎性骨折；内固定；骨外科 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742（2014）03（b）-0011-02 　　[Abstract] Objective To investigate the clinical efficacy of 3 kinds of internal fixations for femoral intercondylar comminuted fracture. Methods The eligible patients with femoral intercondylar comminuted fracture underwent open reduction were given ordinary steel plate internal fixation（group A），condylar buttress plate internal fixation（group B）and dynamic condylar screw fixation（group C）.And sanders clinical condition score and postoperative complications of three groups were compared.Results It showed that there were no statistically significant differences in Sanders clinical scores between the three groups of patients（P 0.05）.Of the three groups，the incidence of complications of group A was the highest，but compared that with group B and group C，the difference was not statistically significant（P 0.05）.Conclusion Open reduction and internal fixation for femoral intercondylar comminuted fracture are conducive to the recovering of joint function； there is no difference in the aspect of clinical effect between these three kinds of internal fixations in clinical practice，and no significant effect on the quality of surgery. 　　[Key words] Femoral intercondylar comminuted fracture； Internal fixation； Bone surgery 　　股骨髁间粉碎性骨折是在高能量损伤下造成的关节内骨折，除累及关节面外，可伴有其他部位损伤，故临床治疗上难度较大，术后可能残留膝关节功能障碍等后遗症。为探讨3种内固定对股骨髁间粉碎性骨折的临床疗效，该院自2011年5月―2013年5月，对股骨髁间粉碎性骨折患者手术切开复位后分别采用普通钢板内固定、髁支持钢板内固定及动力髁部螺丝内固定进行比较，取得了不同的疗效，现将结果报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择该院诊断为股骨髁间粉碎性骨折的患者共120例，所有患者均在术前行常规X线片或CT扫描后确诊。其中男性84例，女性36例，年龄24～69岁，平均38.5岁。骨折均为高能量暴力所致，其中车祸伤56例，撞击伤21例，坠落伤43例。根据患者骨折类型不同予不同处理措施，如开放型骨折可先行清创后骨牵引，术后