实用医学杂志 ›› 2022, Vol. 38 ›› Issue (5): 611-615.doi: 10.3969/j.issn.1006⁃5725.2022.05.017

• 临床研究 • 上一篇    下一篇

下肢轴向牵引器与徒手复位在股骨远端骨折钢板内固定术中的疗效

周楠 马明亮 刘宏智 赵冬阳 王志刚   

  1. 滨州医学院附属医院创伤骨科（山东滨州 256603）

  • 出版日期:2022-03-10 发布日期:2022-03-10
  • 通讯作者: 王志刚 E⁃mail：wangzghn@163.com
  • 基金资助:
    山东省医药卫生科技发展计划（编号：2017WS229）；滨州医学院科研计划项目（编号：BY2019KJ31）

Comparison of reduction via a lower extremity axial distractor and manual reduction for distal femoral fracture with plate fixation

ZHOU Nan，MA Mingliang，LIU Hongzhi，ZHAO Dongyang，WANG Zhigang.   

  1. Department of Orthopedics and Trauma，Affiliated Hospital of Binzhou Medical College，Binzhou 256603，China

  • Online:2022-03-10 Published:2022-03-10
  • Contact: WANG Zhigang E⁃mail：wangzghn@163.com ​

摘要：

目的 通过与传统徒手复位比较，探讨下肢轴向牵引器辅助闭合复位钢板内固定治疗股骨远端骨折的疗效及优势。方法 回顾性分析 2017 年 5 月至 2019 年 6 月于我院行闭合复位钢板内固定治 疗的 57 例股骨远端骨折患者资料。其中 26 例采用下肢轴向牵引器复位（观察组），31 例采用徒手复位（对 照组）。两组患者在性别、年龄及 AO 分型上差异无统计学意义（P > 0.05）。结果 所有患者均顺利完成 手术，对照组 3 例术中行切开复位，两组患者均无并发症发生。与对照组相比，观察组患者在手术时间上 较对照组有减少趋势但差异无统计学意义，观察组在术中透视次数及出血量方面均明显减少且差异有统 计学意义（P < 0.05）。观察组随访时间为（13.35 ± 2.34）个月，骨痂形成时间为（2.81 ± 0.89）个月，发生膝关节僵硬 2 例，发生术后切口感染 1 例。对照组随访时间为（16.45 ± 5.10）个月，骨痂形成时间为（2.16 ± 0.87）个月，发生膝内翻2例，膝关节僵硬2例。术后1年对患肢功能进行评估：观察组：优20例，良6例，优良率 96.30%。对照组：优 23 例，良 7 例，优良率 96.77%。结论 下肢轴向牵引器辅助闭合复位内固定治疗股骨 远端骨折具备透视次数少、复位效率高的优点，临床效果满意。

关键词:

股骨远端骨折, 下肢轴向牵引器, 闭合复位, 内固定, 钢板, 手法复位

Abstract:

Objective The effects and advantages of lower extremity axial distractor（LEAD）adopted for distal femoral fracture reduction was discussed by comparing with manual reduction. Methods From March 2017 to June 2019，57 distal femoral fractures with closed reduction and internal fixed with plate were reviewed，including 26 cases with LEAD（test group）and 31 cases with manual reduction（control group）. There were no significant differences of gender，age and AO classifications between the two groups（P > 0.05）. Results All of these 57 patients were completed the operation with 2 cases got open reduction in the control group and none in the test group，and no complications were encountered. The operation time in test group had a decreased trend compared with the control group but the difference had no statistical significance. The imaging times and blood loss in test group were decreased apparently with statistical differences（P < 0.05）. Patients from both of these two groups were followed up. The mean time of it in test group was（13.35 ± 2.34）months and the callus formation time was（2.81 ± 0.89） months，including 2 cases with stiffness of the knee joint and 1 case with infection of post⁃operative incision. The mean time of following in control group was（16.45 ± 5.10）months and the callus formation time was（2.16 ± 0.87） months，including 2 cases with genu varum and 2 cases with stiffness of the knee joint. The assessments of the affected limbs after 1 year were adopted and the results showed that there were 20 excellent patients and 5 good patients in test group，the superior rate of it was 96.30%. In the control group，there were 23 excellent patients and 7 good patients with the superior rate of 96.77%. Conclusion The reduction via LEAD and internal fixed with plate to deal with the distal femoral fracture has less imaging times and better efficiency than that by manual reduction， which has a good clinical effect.

Key words: the distal femoral fracture,  , lower extremity axial distractor（LEAD）,  , closed reduction,  , internal fixation,  , plate,  , manual reduction

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