改良前外侧入路治疗股骨下端粉碎性骨折

目的探讨改良前外侧入路钢板内固定治疗股骨下端粉碎性骨折的临床效果。方法自2008年8月—2012年1月采用改良前外侧入路钢板内固定治疗股骨下端粉碎性骨折78例。结果随访10个月～2年,所有病例无螺钉松动、钢板断裂、肢体短缩及膝关节内外翻畸形愈合等并发症,73例骨折完全愈合,5例骨折不愈合经二期髂骨植骨后骨性愈合,膝关节功能优良率达91%。结论改良前外侧入路钢板内固定治疗股骨下端粉碎性骨折,操作简单、舒服,复位满意,固定可靠,手术创伤小,保护伸膝装置的完整性,有利于骨折愈合及膝关节早期功能锻炼,术后恢复快,疗效确切。

Improved anterolateral approach to treatment of terminal femoral fractures

Objective To explore the clinical effects of internal fixation with plate by the improved anterolateral approach to treatment of terminal femoral fractures.Methods Internal fixation with plate by improved anterolateral approach was applied to 78 patients with complex comminuted bone fractures of terminal femora from August 2008 to January 2012.Results During the follow-up of 10 months to 2 years,73 patients reached complete healing without screw relaxation,plate rupture and malformation(e.g.limb shortening and knee varus or eversion);the other 5 ones who suffered from nonunion reached complete healing by the second stage bone grafting.The excellent and good rate of knee joint function was up to 91 %.Conclusion With simple procedure,reliable fixation,integral protection of knee extensor device,mini-operative damage and propitiousness to functional recovery of knee joint,the internal fixation with plate by the improved anterolateral approach is a relatively good therapeutic approach to the complex comminuted bone fractures of terminal femora.