摘要
目的探讨钢板与聚乙烯板互锁固定治疗累及髁部的股骨长节段粉碎性骨折的疗效。方法回顾分析1999年1月～2004年12月28例累及髁部的股骨长节段粉碎性骨折手术治疗的临床资料。采用AO分类法,均为C型骨折,其中C1型7例,C2型12例,C3型9例;应用AO股骨髁支撑钢板与高分子量聚乙烯板互锁固定,即在股骨外侧放置AO髁支撑钢板,内侧放置一块比钢板稍小的高分子量聚乙烯板,根据骨折固定需要任意钻孔,用螺钉将外侧钢板与内侧对应的聚乙烯板互锁固定,术后进行科学合理的康复治疗。结果28例患者术后随访8～42个月,平均20.8个月,骨折均获临床愈合,愈合时间为4.8～14.0个月,平均6.5个月。按Kolmert等评价标准:优13例,良7例,可6例,差2例,优良率达71.4%。结论互锁双板可同时发挥外侧钢板的支撑稳定作用和内侧聚乙烯板的内夹板样保护作用,有利于骨折的整复、固定和早期功能锻炼;聚乙烯板的大小、形状可根据术中需要灵活选择与塑形,临床应用操作方便。互锁双板固定设计理念先进,符合生物力学原理,固定效果可靠,临床应用方便,为临床治疗累及髁部的股骨长节段粉碎性骨折提供了一种新的技术方法。
Objective To explore the clinical effect of the interlocked double-plate in treating long segmental comminuted fracture of the femoral diaphysis and condyles. Methods We retrospectively studied the clinical data of 28 patients with long segmental comminuted fracture of the femoral diaphysis and condyles who were admitted to our hospital from January 1999 to December 2004. According to AO classification, all the 28 cases belonged to type C （7 cases of Type C1, 12 cases of type C2 and 9 cases of type C3） . They were treated with the interlocked double-plate. The supporting steel plate was placed on the lateral side and the smaller polyethylene plate on the medial side. The 2 plates were interlocked through holes drilled and fixed with screws according to the need of the bone fixation. Scientific and rational rehabilitation was carried out for each case after the operation. Results The postoperative follow-ups ranged from 8 to 42 months, with an average of 20.8 months. All the fractures healed well, and the average clinical healing period was 6.5 months （from 4.8 to 14.0 months）. According to Kolmert＇s criteria, excellent results were found in 13 cases, good in 7, fair in 6, and poor in 2. The excellent and good rate was 71.4%. Conclusions Since the interlocked double-plate provides both stable support of the lateral steel plate and the protection of the splint of the medial polyethylene plate, it facilitates reduction of the fracture, fixation and early functional exercise. The size and shape of the polyethylene plate can be chosen and moulded according to specific operative needs. The interlocked double-plate is a new effective device in treating long segmental comminuted fracture of the femoral diaphysis and condyles because of its reasonable design, reliable fixation and convenient clinical application.
出处
《中华创伤骨科杂志》
CAS
CSCD
2005年第11期1028-1032,共5页
Chinese Journal of Orthopaedic Trauma
基金
广东省医学科学技术研究基金资助(A1998336)
