股骨远端骨折手术治疗的回顾性研究

目的探讨采用切开复位内固定术治疗股骨远端骨折的临床效果。方法对1999年1月至2009年1月收治的采用切开复位内固定治疗且获得完整随访资料的19例股骨远端骨折患者进行回顾性分析,男10例,女9例;年龄23～83岁,平均59岁;左侧6例,右侧13例。按照AO分型：A型9例,B型5例,C型5例;根据Neer分型：I型5例,Ⅱ型9例,Ⅲ型5例。闭合性骨折16例,开放性骨折3例,合并其他部位骨折6例,其中合并同侧胫骨平台骨折2例,同侧髌骨骨折1例,同时合并同侧胫骨平台及髌骨骨折1例。受伤至入院时间1 h～6 d,平均22.6 h。对术后患者的膝关节活动度、功能及患者满意度进行评定。结果随访时间4～76个月,平均35.9个月。无一例患者出现伤口感染,内固定松动、断裂。1例患者出现骨折延迟愈合,经二次手术植骨后好转。所有患膝关节伸直均达0度,屈曲平均达122.4度,无内外翻畸形,关节内骨折患者无明显创伤性关节炎表现。膝关节功能HSS评分平均85.1分,优良率94.7%;Lysholm评分83.6分,优良率89.5%。患者对治疗的满意率平均为82.1%。结论采用切开复位内固定结合植骨并早期功能锻炼治疗股骨远端骨折,有利于膝关节功能的早期恢复,结果满意。

A retrospective research on treatment of distal femoral fractures with open reduction and internal fixation

Objective To investigate the clinical results of treatment of distal femoral fractures with open reduction and internal fixation（ORIF）.Methods Sixty cases of distal femoral fracture were treated with ORIF in our department after January 1999.Nineteen cases of them got full follow-up for 4 to 76 months.Their knee functions were evaluated through clinical checkups and functional evaluations by HSS（The Hospital for Special Surgery） scoring system and Lysholm Questionnaire.Results None of the 19 fractured patients had infection or internal-fixation failure.One case failed to obtain union 5 months postoperatively and had to receive another bone graft operation before bone-healing.At the last follow-up,the average HSS score：85.1;Lysholm score;83.6.All the average scores were excellent.Conclusion ORIF is a valuable treatment for distal femoral fractures,because it can recover and improve the functions of knees of patients more quickly.