摘要
目的探讨U形切口双钢板固定治疗股骨远端C3.3型骨折的可行性及临床疗效。方法 2006年7月-2009年2月,收治股骨远端C3.3型骨折11例。男7例,女4例;年龄27～55岁,平均43岁。车祸伤8例,高处坠落伤3例。左侧6例,右侧5例。开放骨折5例,闭合骨折6例。受伤至入院时间30min～7d。入院予骨牵引3～8d后行U形切口双钢板固定术,同时取自体髂骨或异体骨植骨治疗。结果手术时间105～150min,平均128min;术中出血量290～380mL,平均344mL。术后1周2例出现局部皮缘浅层坏死,经对症处理后愈合;其余切口均Ⅰ期愈合。患者均获随访,随访时间12～36个月,平均22个月。X线片复查示骨折于术后3～6个月愈合,平均4.4个月。末次随访时按Merchan等疗效评定标准进行膝关节功能评定:优4例,良5例,可1例,差1例,优良率为81.8%。结论采用U形切口双钢板固定治疗具有术野显露清晰、手术操作简便、骨折解剖复位及固定牢靠等优点,是治疗股骨远端C3.3型骨折的有效方法之一,但应严格掌握手术指征及操作规程。
Objective To investigate the efficacy of double-plating fixation via U-shaped incision in the treatment of type C3.3 distal femoral fractures.Methods From July 2006 to February 2009,11 cases of type C3.3 distal femoral fractures were treated,including 5 open fractures and 6 closed fractures.Among them,there were 7 males and 4 females with an average age of 43 years（range,27-55 years）.The locations were left side in 6 cases and right side in 5 cases.Fracture was caused by traff ic accident in 8 cases and falling from height in 3 cases.The time from injury to hospitalization was 30 minutes to 7 days.After bone traction for 3 to 8 days,the operations were performed by double-plating fixation via U-shaped incision,and autograft of iliac bone or allogeneic bone grafting.Results The average time of operation was 128 minutes（range,105-150 minutes）.The average blood loss during operation was 344 mL（range,290-380 mL）.Shallow local skin flap necrosis occurred in 2 cases,and incision healed by first intention in others patients.All patients were followed up 22 months on average（range,12-36 months）.The bone union was achieved within 3-6 months（4.4 months on average）.No implant loosening or refracture was found.According to Merchan et al criteria for knee joint function evaluation,the results were excellent in 4 cases,good in 5 cases,fair in 1 case,and poor in 1 case at last follow-up;the excellent and good rate was 81.8%.Conclusion The double-plating fixation via U-shaped incision has the advantages of better exposure,great convenience to manipulation,anatomical reduction,and rigid fixation.It provides an effective treatment for type C3.3 distal femoral fracture.However,its operation indications and operating instructions should be strictly followed.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第6期683-686,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
股骨远端骨折
C3.3型骨折
手术入路
双钢板固定
Distal femoral fractures Type C3.3 fractures Operative approaches Double-plating fixation
