股骨髁部C3型骨折35例的手术治疗

目的 评价股骨髁部C3型骨折的手术治疗效果.方法 对我院自2007年12月至2010年4月期间收治的35例股骨髁部骨折病人分别采用克氏针、空心拉力钉、解剖型锁定钢板以及DCS实施内固定治疗.结果 本组全部35例病人进行随访18～30个月,平均为24个月.病人术后的膝关节功能恢复以及主观满意度评估情况:分值在85 ～ 100分为优,共18例(18/35,51.43％)；分值在70～80分为良,共9例(9/35,25.71％),分值在60～69分为可,共7例(7/35,20.00％),分值小于60分者为差,共1例(1/35,2.86％),优良率达77.14％ (27/35).术后有33例病人达到骨性愈合,余者2例病人骨延期愈合.有严重创伤性膝关节炎患者1例,最终疗效评估为差.结论 对股骨髁部C3型骨折患者进行早期手术治疗,重视解剖复位及牢靠内固定,临床疗效较为满意.

Surgical Treatment of 35 Cases of Femoral Ccondyle Type C3 Fracture

Objective To evaluate the effect of surgical treatment of type C3 fractures of the femoral condyle. Methods Thirty-five cases of partients with femoral condyle fractures were treated by Kirschner wire, hollow pull nails, anatomical type locking plate and DCS internal fixation. Results All the patients were followed up for 18 to 30 months, with an average of 24 months. The evaluation of knee functional recovery and subjective satisfaction after operation were as follows： evaluation score in 85 to 100 was excellent, which included 18 cases （18/35, 51.43%）; evaluation score in 70 to 80 were fine, which included 9 cases （9/35, 25.71%）; evaluation scores in 60 to 69 were tolerableness, which included 7 cases （7/35, 20.00%）; evaluation score less than 60 were poor, which included 1 case （1/35, 2.86%）; the excellence rate with good and fine was 77.14% （27/35）. Bony union was obtained in 33 cases, and delayed heal in other 2 cases. Finally curative effect evaluation was poor in 1 case with severe traumatic knee arthritis. Conclusion Eearly surgical treatment for partients with femoral condyle C3 fractures, anatomical reattachrnent and firm internal fmation can obtain satisfactory clinical efficacy.