双钢板固定治疗股骨远端骨折.doc

前正中纵形切口双钢板固定治疗C3型股骨远端骨折摘要：目的 探讨前正中纵形切口双钢板固定治疗C3型股骨远端骨折的临床疗效和可行性。方法 2008年8月—20年月，收治C3型股骨远端骨折12例。男8例，女4例：年龄25-55岁，平均40岁。车祸伤9例，高处坠落伤3例。左侧7例，右侧5例。开放性骨折5例，闭合性骨折7例。受伤至入院时间20min-5d。入院给予胫骨骨牵引5-8d后行前正中纵形切口双钢板内固定术，伴骨缺损者给予自体或异体骨植骨治疗。末次随访时按Merchan评分标准评估结果 手术时间110-160min，平均135min；术中出血量约300-500ml，平均400ml。术后伤口均Ⅰ期愈合。患者均获随访，随访时间1-3月，平均2月。复位满意，无术后感染、骨不连、深静脉血栓形成等并发症。骨折愈合时间为-24周，平均21周。末次随访时按Merchan评分标准评估：优4例，良6例，可1例，差1例，优良率为83.3%。结论 采用前正中纵形切口双钢板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C3型股骨远端骨折的有效方法之一，但应严格掌握手术指征及操作规程。关键词 C3型骨折 股骨远端骨折 手术入路 双钢板固定 中图分类号：R683.42 R687.32 文献标志码：A’s hospital, Linfen Shanxi, 041000,P.R.China.Correspnding author: ZHANG Zhimin, E-mail:Focus_2﹫bstract】 Objective To investigate the clinical efficacy and feasibility of double-plating fixation via pre-longitudinal incision in the treatment of type C3 distal femoral fractures. Methods From August 2008 to August 2011, 12 cases of type C3 distal femoral fractures were treated, 作者单位：临汾市人民医院骨科﹙山西临汾，041000﹚ 作者简介：张志敏，主治医师，硕士，研究方向：创伤、关节，E-mail:Focus_2﹫Among them, there were male 8 cases, 4 were female: age 25-55 years old, an average of 40 years old. The locations were left side in 7cases and right in 5 cases. Car accident injury 9 cases, injury by falling in 3 cases. The time from injured to hospital was 20 minutes to5 days. After the tibia bone traction for 5 to 8 days, the operations were performed by double-plating fixation via pre-longitudinal incision, and autograft of iliac bone or allograft bone grafting. According to the Merchan et al criteria for knee joint function evaluation. Results The operation time was from 110 to160 minutes, on average 135 min, the blood loss during operation was from 300ml to 500ml, an average of 400 ml. Post-operative wound wereⅠperiod healing. All patients had been followed up, the follow-up time was from 16 to 36 months, an average of 24 months. With no infection, reduction, nonunion, deep vein thrombosis complication after operation. The bone healing time for 18 to 24 weeks, a