股骨下端复杂骨折内固定方法的选择

目的　为使股骨下端复杂骨折达到最佳治疗效果 ,探讨如何根据不同骨折类型选择不同内固定器材。方法　应用AO股骨髁支持钢板 15例 ,动力髁部螺钉 11例 ,股骨髁上逆行交锁髓内钉 6例分别治疗此类骨折共 32例 ,全部病例进行临床随访评定效果。结果　 32例经 6～ 36个月 (平均 11 5个月 )随访 ,骨折均获愈合 ,平均愈合时间为 5个月。术后功能恢复 ,总优良率达 87 5 %。结论　动力髁部螺钉、股骨下端逆行交锁髓内钉在治疗 33—A、B、C1型骨折中优于股骨髁支持钢板。股骨髁支持钢板适用于所有 33—A、B、C各型骨折 ,特别在治疗 33—C2、3 型骨折中优于动力髁部螺钉和股骨下端逆行交锁髓内钉

Selection of Internal Fixation Methods for Treatment of Complicated Fractures in Distal Part of Femur

Objective In order to obtain the best effect of treating the complicated fracture of the distal part of femur,we have explored how to choose different internal fixation materials according to different fracture types.Methods Applying the supporting steel of AO condyles of femur in 15 cases,the screw of dynamic condyle in 11 cases and the retrograde and interlocking screw in the supra-condyles of femur in 6 cases.We have treated this kind of fracture respectively in total 32 cases.We have made the clinical investigation into all the cases and appraised the effect.The results were as follows.Results Through 6~36 months investigation(average 11.5 months),the fracture union was obtained for all the fractures.the average time for fracture umion was 5 months.After operations,the functions were recovered and the excellent and good rates is 87.5%.Conclusion In treating the fractures of the 33-A,B,C 1 types,the screw of dynamic condyle and the retrograde and interlocking screw in the distal part of femur are better than the supporting steel plate of femur,The supporting steel plate is suitable for all the fractures of the 33-A,B, especially in treating the 33-C 2?C 3 types,the supporting steel plate of femur is better than the screw of dynamic condyle and the retrograde and interlocking screw in the distal part of femur.