股骨远端骨折内固定方式选择探讨.docVIP

股骨远端骨折内固定方式选择探讨 　　中图分类号：R683.42文献标识码： A文章编号： 1814-8824(2008)-4-0005-03 　　摘要：目的 探讨动力髁钢板螺钉(DCS)和逆行交锁髓内钉(GSH)，股骨髁支撑钢板、双头螺纹空心钉螺钉，可吸收螺钉，治疗股骨远端骨折的方法与效果。方法 对我院对2000年至2008年1月治疗的62例该骨折的内固定方式进行对比，按照AO分类；A1型13例A2型4例，A3型7例，B1型3例，B2型2例，B3型2例，C1型9例，C2型12例，C3型10例。采用DCS内固定31例，可吸收螺钉2例，采用GSH内固定13例，采用髁支撑钢板内固定11例，空心钉5例。进行比较。结果 随访6月~2.5年，平均10月。骨折愈合时间4月~1.5年，平均8月。根据KOLMERT膝关节功能评分，优28例，良21例，可13例，优良率为79%。并发症3例，发生率为5%。结论 几种治疗方法均可对股骨远端获得满意效果，但各有适应症，不可一概而论，选择适宜内固定方式，可缩短手术时间，减少组织剥离及损伤。减少出血，减少制动，增加骨折内固定的稳定性。可适时早期功能锻炼，缩短膝关节功能恢复时间，减少膝关节功能受限的可能。 　　关键词 股骨远端骨折 内固定 动力髁螺钉 逆行交锁髓内钉 股骨远端髁支撑钢板 可吸收螺钉 双头螺纹空心钉 　　Research on Selecting the Internal Fixation Modes for Distal Femoral Fracture.Zhao Jun，Zhang Ming-Hua，Xiao Shan-Yong，et al.Longquanyi District Hospital of TCM ，Chengdu 610100，Sichuan，China. 　　【Abstract】Objective To explore methods and effects of distal femoral fracture treated with dynamic condylar screw (DCS)，retrograde interlocking intramedullary nail (GSH)，condylar buttress plates，double head hollow compression screws and absorbable screws respectively.Methods Contrast analysis of the internal fixation modes for distal femoral fracture which adopted by 62 patients from 2000 to Jan. 2008 was made.The fractures were classified as AO type-A1 in 13 cases ，type-A2 in 4cases，type-A3 in 7 cases ，type-B1 in 3 cases ，type-B2 in 2 cases，type-B3 in 2 cases，and type-C1 in 9 cases ，type-C2 in 12 cases，type-C3 in 10 cases. 31 cases adopted DCS internal fixation ，absorbable screws were used for 2 cases，and 13 cases by using GSH internal fixation ，11 by using condylar buttress plates ，5 by using hollow nail.Result All patients were followed for 66 months to 2 and a half year. Mean follow up time was 10 months . The union time was 4 months to 1 and half year，and the average time was 8 months .The KOLMERT knee joint score were used to assess the function of the knees . 28 cases was excellent ，12 cases was good ，3 cases was fair ，the excellent rate of the knee joint was 79%. Complications occurred in 3 cases ，a