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股骨远端骨折包括髁上和髁间的骨折,多系直接暴力所致的高能损伤,治疗困难且易出现后遗症。我院自1999-2003年共收治20例该类患者,均采用手术治疗,根据不同骨折类型分别采取95°髁钢板、髁支持钢板、动力髁螺钉(DCS)行内固定,疗效满意,报告如下。1临床资料本组20例,男16例,女4例;年龄20~55岁,平均34岁。左侧8例,右侧12例。致伤原因:交通事故伤13例,重物砸伤3例,高处坠落伤4例。合并骨盆骨折2例,合并同侧髁间骨折5例,创伤性休克2例,合并血气胸1例,合并颅脑损伤1例,合并腹内脏器损伤1例。骨折类型:闭合性16例,开放性4例。开放骨折据Gustilo… 相似文献
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目的:探讨股骨远端骨折手术治疗的方法和临床疗效。方法选择股骨远端骨折手术治疗37例,根据AO/A S IF分型,A型8例,B型9例,C型20例,分别采用股骨髁支持钢板、L-梯形钢板、逆行带锁髓内钉、拉力螺钉进行固定,术后随访6个月~8年。结果6例骨折不愈合、3例出现化脓性骨和膝关节感染、3例出现钢板断裂。根据K olm enrt股骨远端功能评定标准,优17例,良14例,一般2例,差4例,优良率83.7%。结论手术治疗股骨远端骨折能最大限度获得骨折复位和膝关节功能的恢复,临床疗效满意,是治疗股骨远端骨折较理想的方法。 相似文献
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股骨远端骨折因其解剖结构临近膝关节,是股骨髁至股骨干的联结部,是密质骨和松质骨移行部位;由于股骨髁上区域皮质薄、粉碎、骨质疏松和髓腔宽,过去使用内固定治疗比较困难,治疗疗效远不甚满意.近年来随着内固定技术和材料的发展,多数医生采用了各种内固定方法治疗股骨远端骨折.1997年至2003年本院采用手术治疗38例患者.其中DCS内固定17例,逆行交锁髓内钉内固定23例.骨折对位准确,内固定牢固,术后功能恢复满意.现报告如下. 相似文献
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股骨远端骨折的手术治疗 总被引:26,自引:7,他引:26
目的探讨股骨远端骨折的手术治疗方法及合并症的预防。方法对1991年~2001年,348例股骨远端骨折手术治疗,选用螺钉、动力加压钢板(DCP)、角钢板、动力髁部螺钉(DCS)、股骨髁钢板、带锁髓内钉治疗股骨远端骨折。研究内固定物的使用、骨折复位、植骨、骨折不愈合等相关问题。结果13例发生内固定失效、钢板断裂,需要重新固定植骨。8例延迟愈合,二期植骨。其余骨折均愈合。14例术后伤口感染,18例晚期出现肢体短缩,范围1~4cm。52例因骨折愈合后膝关节屈曲小于90°需要行松解手术。结论手术治疗股骨远端骨折能够恢复解剖结构,从而最大限度地恢复肢体的功能。 相似文献
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应用不同内固定方法治疗股骨远端骨折的疗效分析 总被引:7,自引:0,他引:7
目的比较分析应用不同内固定方法治疗股骨远端骨折的疗效。方法对86例成人股骨远端骨折应用切开复位分别L形钢板(30例)、动力髁螺钉(Dynamic Condylar Screw,DCS)(22例)、髁上交锁髓内钉(36例)固定的方法进行治疗,术后随访1a以上,对其骨折愈合时间、膝关节活动度、短缩及畸形、步态等四项指标进行评价。结果3种固定方法优良率分别为33%(10/30)、36%(8/22)、83%(30/36)。L形钢板与动力髁钢板相比,无显差异,两与髁上交锁髓内钉相比,后明显优于前两。结论髁上交锁髓内钉内固定是目前治疗股骨远端骨折的最好方法,愈合率高,关节功能恢复好。 相似文献
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股骨远端粉碎骨折以往常采用骨端钢板、骨栓、L形钢板、动力髁螺钉等治疗 ,存在固定稳定性差 ,拼接困难 ,髁部易出现内外翻畸形等问题。本院自 1998年 2月采用逆行交锁髓内钉治疗粉碎性股骨远端骨折 2 1例取得满意效果 ,小结如下。临床资料一、一般资料 1998年 2月至 1999年 2月 ,共使用逆行交锁髓内钉治疗股骨远端粉碎骨折 2 1例 ,其中男 13例 ,女 8例 ,年龄 2 1~ 63岁 ,平均 37.5岁。机动车乘员 7例 ,驾驶员 9例 ,其它 5例。骨折原因 :车祸致伤 18例 ,其它 3例。左侧 13例 ,右侧 8例。骨折类型 :开放性 3例 ,闭合性 18列 ;按 Seinahei… 相似文献
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Surgical management of complex fractures of the distal femur 总被引:2,自引:0,他引:2
R D Mize 《Clinical orthopaedics and related research》1989,(240):77-86
Fractures of the distal femur are often complex injuries presenting numerous potential complications. The surgical management of these difficult injuries is based on classification, patient selection, and preoperative planning. The surgical approach and modified extensile approach include four fixation devices. The results with 63 patients and 68 injuries reviewed over a ten-year period consisted of 76% good to excellent results, five malunions, and a 4.4% infection rate. 相似文献
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An emphasis on indirect reduction techniques to restore limb alignment has improved the rate of fracture healing and decreased infection rates, fixation failure, and the need for bone grafting. 相似文献
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双侧板联锁固定股骨远端粉碎性骨折 总被引:7,自引:0,他引:7
目的 为股骨远端粉碎性骨折设计新的内固定方法 ,从生物力学角度提供其科学依据 ,以解决复位困难、固定不牢及内外翻等畸形和并发症。方法 选用 10例新鲜成人尸体股骨 ,在髁上 -髁间截骨造成粉碎性骨折模型 ,用钢板与聚乙烯板双板组合固定 (简称双板固定 ) ,对照组采用传统的单侧钢板固定 (简称单板固定 ) ,分别进行压缩、弯曲、扭转刚度试验和双板固定屈服试验。结果 双板固定组的抗弯曲、抗扭转能力较单板固定组显著增强 (P <0 0 1)。双板固定强度试验 ,其承受轴向载荷可达 115 4 0N ,前、后、内、外弯曲载荷分别可达 70 0、10 82、5 93、10 10N。结论 双板固定股骨远端粉碎性骨折可维持碎骨块解剖复位、增强骨折内固定的稳定性和牢固性 ,能满足早期功能锻炼的需要 相似文献
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This paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. The treatment of distal femoral fractures has improved with the evolution of plating and nailing technologies. The commonly selected surgical approaches are outlined and surgical treatment techniques including both internal and external fixation are discussed. 相似文献
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Intra-articular fractures of the distal femur. 总被引:1,自引:0,他引:1
A J Zimmerman 《The Orthopedic clinics of North America》1979,10(1):75-80
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Growth plate fractures of the distal femur are challenging to treat, with complications that require a secondary surgery 40% to 60% of the time. These fractures often necessitate operative intervention, even in the youngest patients and even with minimal apparent displacement. Treatment varies with the Salter-Harris (SH) classification and with the extent of initial displacement, ranging from simple casting for nondisplaced SH I fractures to open reduction and internal fixation for almost all SH III and IV fractures. Poor outcomes have been associated with pediatric fracture care of SH III and IV in 29% to 32% of cases. There are many pitfalls that have to be avoided in the treatment of these fractures to prevent malunion, growth arrest, and posttraumatic arthritis. 相似文献
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Periprosthetic fractures of the distal femur most commonly present as fragility fractures associated with relatively minor trauma. These injuries are often complicated by osteopenia of the distal femur secondary to stress shielding or osteolysis. Effective management of periprosthetic fractures of the distal femur requires knowledge of both fracture fixation techniques and revision arthroplasty. This article reviews the treatment options for these challenging fractures with a particular focus on the management of displaced fractures with a stable prosthesis. 相似文献
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Between 1980 and 1989, reports on 2,165 fractures of the distal part of the femur (1,051 women and 1,114 men) were collected by AO Documentation and are analyzed in the present paper. The number of fractures showed a bimodal pattern with a marked variation in the number of fractures in relation to gender and age. A larger prevalence of fractures was observed either in young men (about 20 years old, traffic or sport) and in old women (about 70, fall at home, osteoporosis). 相似文献