股骨远端微创固定系统与髁部支持钢板治疗股骨远端C型骨折的疗效分析

目的:分析比较股骨远端微创内固定系统与髁部支持钢板固定治疗股骨远端C型骨折的临床疗效。方法:回顾性分析2003年1月至2010年4月在福建医科大学附属第二医院采用股骨远端微创内固定系统固定治疗的63例(Ⅰ组)及采用髁部支持钢板固定治疗的76例(Ⅱ组)股骨远端C型骨折患者的病历资料,比较2组患者的手术时间、术中出血量、骨折愈合时间及术后3个月、6个月及12个月时的HSS膝关节评分。结果:①Ⅰ组患者的手术时间、术中出血量及骨折临床愈合时间均少于Ⅱ组,差异有统计学意义(U=3.863,P=0.000;U=3.759,P=0.000;U=5.007,P=0.000)。②两组HSS膝关节评分比较,存在时间效应(F=105.801,P=0.000),不存在组别效应(F=0.344,P=0.558),测量时间与处理方案间不存在交互作用(F=0.069,P=0.856)。结论:对于股骨远端C型骨折患者而言,股骨远端微创固定系统和髁部支持钢板固定相比有术中出血量少、手术时间短、骨折愈合快的优势,但二者对患者膝关节功能的疗效无差别。

Analysis on the curative effects of less invasive stabilization system for distal femur and condylar buttress plate in the type C distal femur fractures

Objective：To analyse and compare the clinical curative effects between less invasive stabilization system for distal femur （LISS-DF） and condylar buttress plate （CBP） in the type C distal femur fractures. Methods： The medical records of 139 patients with the type C distal femur fractures treated in The Second Affiliated Hospital of Fujian Medical University from January 2003 to April 2010 were analyzed retrospectively. Sixty-three cases in group I were administrated with LISS-DF,while the others in group 11 were administrated with CBP. The operation time, amount of blood loss,the fracture healing time and HSS knee joint scores evaluated at the 3rd,the 6th and the12nd month after the operation were compared between the 2 groups. Results ： （1）The operation time, amount of blood loss and the fracture healing time of patients in group I were all lower than those of patients in group II , and there was statistical difference between the 2 groups （ U = 3. 863, P = 0.000 ; U = 3. 759, P = 0. 000 ; U = 5. 007, P = 0. 000）. （2）On the aspect of HSS knee joint scores, there was time effect （ F = 105. 801 ,P = 0. 000）and there was no group effect （F = 0. 344 ,P = 0. 558 ）. There was no interaction between measurement time and handling method （F = 0.069 ,P =0. 856）. Conclusion： Compared with CBP,LISS-DF has approximate curative effect on the knee joint functions for the patients with the type C distal femur fractures, but the latter has the advantages of less amount of blood loss, shorter operation time and fracture healing time.