闭合手法复位经皮钢板固定治疗股骨髁上骨折的临床观察

目的：研究闭合手法复位经皮钢板内固定治疗股骨髁上骨折的手法手术联合技术和临床疗效。方法：自2004年1月至2009年12月,纳入观察范围的病例为39例,男24例,女15例;年龄19～81岁,平均47岁。其中根据AO分型：A1型14例,A2型16例,A3型9例。术中主要选用股骨远段解剖板26例,解剖锁定板13例。采用正骨手法和MIPPO技术对上述病例治疗,并行随访和功能评价。结果：随访时间12～24个月,所有患者达到骨性愈合,平均愈合时间为4个月（3～10个月）。按Kolmert等股骨远端骨折功能评估系统评价：优28例,良10例,中1例。结论：在正确掌握手术技术的前提下,充分运用闭合正骨手法复位的技巧,熟悉解剖钢板的几何形态,能在微创下完成钢板治疗股骨髁上骨折的复位固定,并能够取得满意的临床疗效。

Close reduction by manipulation and minimally invasive percutancous plate osteosynthesis for the treatment of supracondylar femur fractures

Objective: To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous plate osteosynthesis(MIPPO) for the treatment of supracondylar femur fractures. Methods: A retrospective study was conducted to analyze 39 patients with the supracondylar femur fractures who had been treated with close reduction by manipulation and MIPPO. There were 24 males and 15 females. The average age of the patients was 47 years old(ranged,19 to 81 years). According to AO fracture classification for the distal femur fractures,there were 14 patients with type A1,16 patients with type A2 and 9 patients with type A3. Results: All the patients were followed up,and the period ranged from 12 to 24 months(averaged 16 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged 4 months). The patients were evaluated according to Kolmert distal femoral fracture functional evaluation system. Twenty-eight patients obtained an excellent result,10 good and 1 fair. Conclusion: This method for the treatment of supracondylar femur fracture can get satisfactory function,high rate of bone union and less complications. Familiar with the close reduction technique and the geometry shape of anatomic plate as well as femoral supracondyar area are important to treat the supracondylar femur fractures.