摘要
目的 分析新型板钉互锁系统内固定治疗AO-B、C型股骨远端骨折的疗效.方法 回顾性分析自2019-01-2022-01诊治的61例AO-B、C型股骨远端骨折,其中36例采用新型板钉互锁系统固定(改进组),25例采用常规单切口股骨远端双钢板固定(常规组).比较两组手术时间、术中出血量、住院时间、完全负重时间,以及术后膝关节活动度、HSS膝关节功能评分、骨折复位质量等指标.结果 所有患者均获得随访,随访时间8～36个月,平均25个月.改进组手术时间、术中出血量、术中透视次数、术后引流出血量均优于常规组,差异有统计学意义(P＜0.05),但两组住院时间差异无统计学意义(P＞0.05).改进组术后下床时间、完全负重时间均早于常规组,而且末次随访膝关节活动度、HSS膝关节功能评分也高于常规组,差异均有统计学意义(P＜0.05).两组末次随访短缩畸形、内外畸形发生率差异无统计学意义(P＞0.05).末次随访两组骨折复位质量差异无统计学意义(P＞0.05),但改进组骨折愈合时间早于常规组,差异有统计学意义(P＜0.05).结论 新型板钉互锁系统内固定治疗AO-B、C型股骨远端骨折的疗效满意,具有损伤小、手术效率高、术中透视次数少、术后恢复快等优点,值得临床推广应用.
Abstract
Objective To analyze the efficacy of a new interlocking system of plate and nail for AO type B,C distal femoral fractures.Methods A retrospective analysis was conducted on 61 cases of AO type B,C distal femoral fractures from January 2019 to January 2022.Thirty six cases were fixed by a new interlocking system of plates and nails(improved group)while 25 cases were fixed with conventional single incision dual plate fixation of distal femoral fractures(conventional group).The surgi-cal time,intraoperative bleeding,hospital stay,complete weight-bearing time,as well as postoperative knee joint range of mo-tion,HSS knee joint function score,and fracture reduction quality between the two groups were compared.Results All pa-tients were followed up for 8-36 months,with an average of 25 months.The surgical time,intraoperative bleeding,intraoperative fluoroscopy frequency,and postoperative drainage bleeding in the improvement group were all lower than those in the conven-tional group,with a statistically significant difference(P＜0.05),but there was no statistically significant difference in hospital stay between the two groups(P＞0.05).The improved group had earlier postoperative time to get out of bed and complete weight bearing than in the conventional group,and the last follow-up knee joint range of motion and HSS knee joint function score in the improvement group were also higher than those in the conventional group,with statistical significance(P＜0.05).There was no statistically significant difference(P＞0.05)in the incidence of shortening and internal and external deformities between the two groups during the last follow-up.There was no statistically significant difference in the quality of fracture reduction between the two groups during the last follow-up(P＞0.05),but the fracture healing time in the improved group was earlier than that in the conventional group,with a statistically significant difference(P＜0.05).Conclusion The new interlocking system of plate and nail for internal fixation in the treatment of AO type B,C distal femoral fractures has a satisfactory therapeutic effect,with advantages such as minimal damage,high surgical efficiency,fewer intraoperative fluoroscopy times,and fast postoperative re-covery.It is worthy of clinical promotion and application.
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