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目的：探讨锁定板 MIPO 技术治疗老年人股骨远端骨折的临床效果。方法：回顾性分析 2009 年 1 月 -2012 年 12 月运用锁定板 MIPO 技术治疗老年人股骨远端骨折患者的临床资料，评估骨折类型、骨折愈合时间、6 个月时的膝关节活动度和膝关节功能评分及临床并发症的发生情况。结果：共纳入 33 例老年人股骨远端骨折患者，平均年龄 72 岁，其中 2 例随访失败。 87%的股骨远端骨折是关节外骨折；骨折平均愈合时间为 1 2.56 (8~29) 周；术后 6 个月时平均活动范围超过 105° ：伸 0° ~30° ，屈 90° ~1 40° ；术后 6 个月的平均膝功能评分 89.5；治疗过程中无植入失败、骨折不愈合和感染发生；术后早期发生下肢深静脉血栓 (DVT)7 例 (22.6%)，均在膝关节水平以下。结论：锁定板结合 MIPO 技术是一种治疗老年人股骨远端骨折安全有效的方法，但要注意预防术后 DVT 的发生。

英文摘要:

Objective:To evaluate the clinical therapeutic effect of locking plates combined with MIPO technique on the elderly patients with distal femur fractures.Methods:From January 2009 to December 2012, a total of 33 elderly patients (average age 72 years) with distal femur fractures treated by the MIPO technique were reviewed retrospectively. The parameters including classification of fractures, time to fracture union, knee range of motion, knee functional scores (refered to AKS score standard) on 6 months, and other apparent complications were analyzed. Two patients were lost to in the follow-up visit.Results:87% of the fractures were extra articular. The average time to union was 1 2.56 (range: 8-29) weeks. The average range of knee motion achieved at 6 months and beyond was 1 05° ranging from 0 to 30° (extension) to 90 to 1 40° (flexion). Functional knee scores at 6 months from fixation were satisfactory (average score 89.5). There was no case of implant failure, nonunion, infection as well. There were 7 (22.6% ) patients developing deep vein thrombosis (DVT) in the early postoperative period, all of which were below the level of the knee joint.Conclusion:Locking plates combined with MIPO techniques was effective and safe in the treatment of the elderly patients with distal femur fractures, but the post operative DVT should receive close attention at the same time.

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