股骨远端粉碎性骨折三种内固定的疗效比较

目的:总结三种内固定治疗股骨远端粉碎性骨折的临床疗效。方法:45例股骨远端粉碎性骨折采用逆行带锁髓内钉、拉力螺丝钉配合动力髁螺钉系统、髁支持钢板治疗并配合术后早期膝关节功能锻炼。结果:平均随访13个月,43例骨折正常愈合,2例延迟愈合;平均骨折愈合时间为5.4个月。按K o lm enrt评定标准,优良率分别为:逆行髁上髓内钉9 3.3%(P<0.0 5),拉力螺丝钉配合动力髁螺钉系统8 6.7%(P<0.0 5),髁支持钢板治疗8 0.0%(P>0.05)。膝关节活动度55～118,°平均膝关节活动度97°。结论:逆行带锁髓内钉和拉力螺丝钉配合动力髁螺钉系统治疗股骨远端粉碎性骨折效果明显,优于髁支持钢板。

Comparative efficacy of three internal fixation methods for distal femoral shattered fractures

Objective:To summarizes clinical curative effect of three internal fixation methods for distal femoral shattered fractures.Methods:Forty-five cases of distal femoral fractures were treated:supracondylar intramedullary in-terlocking nail,dynamic condylar screw matached with tensile screw and compressed plate fixation.After the surgery,the early time carried on the knee joint function exercise.Results:With averaged 13 months fellow-up,43 fractures healed,2 cases healed delayed,and mean union time was 5.4 months.According to the evaluational standard of Kolmenrt:good and excellent are 93.3% for supracondylar in-tramedullary interlocking nail(P<0.05),86.7% for dynamic condylar screw matached with tensile screw(P<0.05),and 80.0% for compressed plate(P>0.05).The knee range of motion was 55～118°,the average activity of knee was 97°.Conclusion:Supracondylar intramedullary in-terlocking nail and dynamic condylar screw matached with tensile screw were effective for the treatment of distal femoral shattered fractures,were better than compressed plate fixation.