股骨远端骨折74例外科治疗与临床分析

目的：探讨股骨远端骨折的不同固定方法并评价不同方法治疗股骨远端骨折的临床疗效。方法：回顾性分析我院1998年6月至2006年6月收治的74例股骨远端骨折患者的骨折类型及内固定方法,并随访其疗效。结果：经过0.5-8年随访,逆行交锁髓内钉治疗组骨折愈合率95.7%,股骨髁支持钢板的骨折愈合率为82.3%,均无1例感染。动力加压钢板（DCP）的骨折愈合率为73.3%,动力髁部螺钉（DCS）的骨折愈合率为84.2%,2组中各有2例和l例出现骨不愈合或延迟愈合,骨折平均愈合时间分别为5个月、6.5个月、7个月和6个月。结论：根据股骨远端骨折类型,选择不同的内固定物。逆行交锁髓内钉治疗适应证广,操作方便,固定坚强,有利于早期下床,而动力加压钢板、髁支持钢板和动力髁部螺钉对关节没有破坏,有利于膝关节功能恢复。

Clinical Evaluation of Internal Fixation Devices Commonly Used for 74 Cases with Distal Femoral Fracture

Objective:To evaluate the clinical effect of different internal fixation devices commonly used for distal femoral fractures.Method:From 1998 to 2006,74 cases with distal femoral fractures were treated with the retrograde intramedullary nail,the condylar supporting femoral plate,dynamic compressed steel plate(DCP) or dynamic condylar screw(DCS).Retrospective analysis was applied to analyze the classification of fracture and internal fixation methods and therapeutic effects were followed.Results:An average of 5 months to 8 years follow-up was carried out.In retrograde intramedullary nail group,the cure rate of fracture is 95.7%.In the condylar supporting femoral plate group,the cure rate of fracture is 82.3%,both of them have no infestation case.In DCP group and DCS group,the cure rate of fracture is 73.3% and 84.2%,2 groups have nonunion occurred in 2 and 1cases.The average healing time of 4 groups is 5,6.5,7,6months differently.Conclusions:In order to improve the cure rate of distal femoral fractures,appropriate internal fixation devices should be determined according to the type of fractures,owing to its incompatibility for all these fractures.The retrograde intramedullary nail method has much advantages,such as wide indication,convenient manipulation,firmly fixation,earlier exercise etc.The others have no destroy to joint and be profit to the recovery of knee joint function.