三种内固定处理股骨远端骨折的临床疗效比较(1)
【摘要】 目的：研究顺行髓内钉、逆行髓内钉、锁定加压钢板三种内固定方法处理股骨远端骨折患者的效果。方法：选取本院2011年2月-2015年4月间的65例股骨远端骨折患者，随机分为三组，分别采用顺行髓内钉、逆行髓内钉和锁定加压钢板三种内固定。对三组的手术时间、术中出血量等观察指标进行比较，并且应用Harris评分系统对三组术后的康复情况展开疗效评价。结果：经过三种内固定手术治疗后，逆行髓内钉组的Harris评分、手术时间、术中出血量均明显优于另外两组，差异均有统计学意义(P<0.05)。结论：股骨远端骨折行顺行髓内钉以及锁定加压钢板内固定的处理效果均劣于逆行髓内钉，并且后者具有手术时间短、术中出血量较少等优势，对患者术后早期恢复膝关节功能有一定优势。
【关键词】 顺行髓内钉； 逆行髓内钉； 锁定加压钢板； 内固定； 股骨远端骨折
【Abstract】 Objective： To study the effects of distal femoral fractures patients treated by three methods of internal fixation with anterograde intramedullary nail， retrograde intramedullary nailing and locking compression plate.Method：65 patients with distal femoral fractures in our hospital were selected from February 2011 to April 2015，they were randomly divided into three groups，they were given three kinds of internal fixation，anterograde intramedullary nailing， retrograde intramedullary nail and locking compression plate respectively. The operation time and bleeding volume of the three groups were compared，arris scoring system was applied to three groups for postoperative rehabilitation efficacy evaluation. Result： After three kinds of internal fixation treatment， the Harris score， operation time and bleeding volume of the retrograde intramedullary nail group were significantly better than the other two groups，the differences were statistically significant(P<0.05).Conclusion：The treatment of distal femoral fractures with intramedullary nail and locking compression plate internal fixation are inferior to retrograde intramedullary nailing， and the latter has advantages of short operation time and less bleeding， as well as helping the patients to recover the knee function at the early period of postoperation.
, 百拇医药
【Key words】 Anterograde intramedullary nail； Retrograde intramedullary nail； Locking compression plate； Internal fixation； Distal femoral fractures
First-author’s address：Hospital of Traditional Chinese Medicine of Qiqihar，Qiqihar 161000，China
doi：10.3969/j.issn.1674-4985.2015.35.050
股骨远端骨折在临床急诊和骨科比较常见，因为患者在股骨远端骨折后长时间无法下地活动，所以褥疮、肺部感染也较易出现。现有资料表明，手术治疗是该种疾病比较有效的方法[1-6]。目前此种疾病治疗方案按照内固定种类，可分成锁定加压钢板内固定、顺行髓内钉和逆行髓内钉等[7-9]。本院在研究中发现，逆行髓内钉在对膝关节功能的提升方面，较顺行髓内钉、锁定加压钢板内固定效果更显著。
, 百拇医药
1 资料与方法
1.1 一般资料 选取本科2011年2月-2015年4月确诊为股骨远端骨折的65例患者，其中顺行髓内钉内固定组21例，男10例，女11例；年龄44～84岁，平均(63.5±11.1)岁；采用AO分型：A1型2例，A2型4例、A3型9例，C1型2例，C2型3例，C3型1例。逆行髓内钉内固定组22例，男14例，女8例；年龄44～84岁，平均(63.3±10.8)岁；A1型4例，A2型5例，A3型6例，C1型3例，C2型2例，C3型2例。锁定加压钢板内固定组22例，男12例，女10例；年龄45～80岁，平均(63.2±10.9)岁；A1型5例，A2型4例，A3型6例，C1型3例，C2型2例，C3型2例。三组患者的年龄、性别、AO分型等一般资料比较差异均无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(杨田)
【关键词】 顺行髓内钉； 逆行髓内钉； 锁定加压钢板； 内固定； 股骨远端骨折
【Abstract】 Objective： To study the effects of distal femoral fractures patients treated by three methods of internal fixation with anterograde intramedullary nail， retrograde intramedullary nailing and locking compression plate.Method：65 patients with distal femoral fractures in our hospital were selected from February 2011 to April 2015，they were randomly divided into three groups，they were given three kinds of internal fixation，anterograde intramedullary nailing， retrograde intramedullary nail and locking compression plate respectively. The operation time and bleeding volume of the three groups were compared，arris scoring system was applied to three groups for postoperative rehabilitation efficacy evaluation. Result： After three kinds of internal fixation treatment， the Harris score， operation time and bleeding volume of the retrograde intramedullary nail group were significantly better than the other two groups，the differences were statistically significant(P<0.05).Conclusion：The treatment of distal femoral fractures with intramedullary nail and locking compression plate internal fixation are inferior to retrograde intramedullary nailing， and the latter has advantages of short operation time and less bleeding， as well as helping the patients to recover the knee function at the early period of postoperation.
, 百拇医药
【Key words】 Anterograde intramedullary nail； Retrograde intramedullary nail； Locking compression plate； Internal fixation； Distal femoral fractures
First-author’s address：Hospital of Traditional Chinese Medicine of Qiqihar，Qiqihar 161000，China
doi：10.3969/j.issn.1674-4985.2015.35.050
股骨远端骨折在临床急诊和骨科比较常见，因为患者在股骨远端骨折后长时间无法下地活动，所以褥疮、肺部感染也较易出现。现有资料表明，手术治疗是该种疾病比较有效的方法[1-6]。目前此种疾病治疗方案按照内固定种类，可分成锁定加压钢板内固定、顺行髓内钉和逆行髓内钉等[7-9]。本院在研究中发现，逆行髓内钉在对膝关节功能的提升方面，较顺行髓内钉、锁定加压钢板内固定效果更显著。
, 百拇医药
1 资料与方法
1.1 一般资料 选取本科2011年2月-2015年4月确诊为股骨远端骨折的65例患者，其中顺行髓内钉内固定组21例，男10例，女11例；年龄44～84岁，平均(63.5±11.1)岁；采用AO分型：A1型2例，A2型4例、A3型9例，C1型2例，C2型3例，C3型1例。逆行髓内钉内固定组22例，男14例，女8例；年龄44～84岁，平均(63.3±10.8)岁；A1型4例，A2型5例，A3型6例，C1型3例，C2型2例，C3型2例。锁定加压钢板内固定组22例，男12例，女10例；年龄45～80岁，平均(63.2±10.9)岁；A1型5例，A2型4例，A3型6例，C1型3例，C2型2例，C3型2例。三组患者的年龄、性别、AO分型等一般资料比较差异均无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(杨田)