| 崔浩诚,章 浩,丁 晨,刘培钊,李 笛,纪 方,唐 昊.对侧皮质锁定螺钉与锁定螺钉治疗股骨远端骨折疗效比较[J].,2018,(7):1287-1292 |
| 对侧皮质锁定螺钉与锁定螺钉治疗股骨远端骨折疗效比较 |
| Comparison of Far Cortical Locking Screws and Locking Screws in the Treatment of Distal Femoral Fractures |
| 投稿时间：2017-10-31 修订日期：2017-12-03 |
| DOI：10.13241/j.cnki.pmb.2018.07.018 |
| 中文关键词: 股骨远端骨折 对侧皮质锁定 Motionloc 骨折愈合 |
| 英文关键词: Distal femoral fractures Far cortical locking Motionloc Fracture healing |
| 基金项目:上海市科学技术委员会科研计划项目（17dz2303400） |
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| 中文摘要: |
| 摘要 目的：比较对侧皮质锁定螺钉与锁定螺钉治疗股骨远端骨折的临床疗效。方法：回顾性分析自2013年5月至2016年8月诊治的52例股骨远端骨折患者，采用对侧皮质锁定螺钉+NCB接骨板内固定治疗26例（A组：对侧皮质锁定组），采用锁定螺钉+NCB接骨板内固定治疗26例（B组：锁定螺钉组）。记录两组手术出血量和手术时间、切口长度、内固定治疗后骨折愈合时间、内固定治疗后完全负重时间、内固定治疗后并发症发生率等，在每个随访节点对每位患者进行患肢的正侧位X线平片检查，末次随访时对患肢进行膝关节功能评分，采用美国特种外科医院膝关节评分标准评定患肢功能。骨折愈合的定义为活动时骨折处无痛且在骨折正侧位X线平片上可见到断端骨皮质骨痂连接。术后并发症包括：关节僵硬、内固定断裂、骨不连以及感染等。结果：本研究52例骨折均获得至少12个月的随访。两组在手术相关指标及切口愈合等方面均无明显差异(P 均＞0.05)。在骨折愈合以及完全负重时间方面，A组均显著短于B组(P均<0.05)。末次随访时52例患者患肢膝关节功能：A组：优18例，良5例，差4例，优良率88.5%；B组：优15例，良6例，中4例，差1例，优良率80.8%。两组对比A组优良率显著高于B组(P<0.05)。两组并发症对比无明显差异：A组发生骨不连2例，骨折内固定断裂2例。B组发生骨不连3例，畸形愈合2例。结论：与传统锁定螺钉相比，对侧皮质锁定螺钉在骨折愈合时间、完全负重时间、术后患肢功能优良率方面具有优势，但在并发症发生率方面没有明显差异。对侧皮质锁定螺钉的治疗指征及自身强度还有待大样本、多中心的临床研究进一步明确。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the difference of clinical effects of far cortical locking screws versus locking screws in the treatment of distal femoral fractures. Methods: Retrospective analysis of May 2013 to August 2016 since the diagnosis and treatment of 52 patients with distal femoral fractures which using far cortical locking screws+NCB plate fixation in 26 cases (group A: locking group in far cortical), using locking screws +NCB plate fixation in 26 cases (group B: locking screw group). Records of two groups of surgical bleeding and operation time, incision length, internal fixation after fracture healing time, full weight bearing time after fixation and inter- nal fixation for the treatment of complications, follow-up in each node of each patient were lateral limb X-ray examination, knee joint function score of the the limb at the end of the follow-up, using the hospital for Special Surgery knee limb function evaluation standard for evaluation. The fracture healing was defined as the painless fracture at the active site, and the bony union of the fractured cortical bone could be seen on the X-ray film of the fracture side. Postoperative complications included joint stiffness, fracture of internal fixation, nonunion and infection. Results: In this study, 52 cases of fractures were followed up for at least 12 months. There was no significant dif- ference between the two groups in the operation related indexes and wound healing (P>0.05). In fracture healing and full weight-bearing time, A group was significantly shorter than that of B group (P<0.05). At the last follow-up, 52 patients had knee joint function: group A: excellent in 18 cases, good in 5 cases, poor in 4 cases, the excellent and good rate was 88.5%; group B: excellent in 15 cases, good in 6 cases, moderate in 4 cases, poor in 1 cases, the excellent and good rate was 80.8%. The excellent and good rate of the A group was sig- nificantly higher than that of the group B (P<0.05). There was no significant difference between the two groups in complications: 2 cases of nonunion and 2 cases of fracture internal fixation breakage in group A. In group B, nonunion occurred in 3 cases and malunion in 2 cases. Conclusion: Compared with the traditional locking screws, the far cortical locking screws has advantages in fracture healing time, full weight-bearing time, postoperative limb function of the excellent and good rate, but the rate of complications occurred in no signifi- cant difference. |
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