锁定钢板微创内固定治疗股骨远端粉碎骨折

摘要

目的探讨应用锁定钢板(LCP)采取微创术式治疗股骨远端粉碎骨折的方法和疗效.方法2006年6月~2011年6月，对52例股骨远端粉碎骨折病人(A3、C 型)，男33例，女19例；年龄19~75岁(平均38.5岁)，采用前方的髌旁切口入路，精确复位关节面后，经皮肌肉隧道插入锁定钢板固定，术后有计划的康复锻炼.结果骨折均获得骨性愈合，平均愈合时间18.2周(14~24周)，浅表感染2例，发生下肢深静脉血栓形成2例，无内固定物断裂骨折再移位者.按Kotmert股骨远端功能评价法，优28例，良19例，可5例；优良率90.4%.结论 LCP经前方的髌旁切口入路，微创插板固定治疗股骨远端粉碎骨折，提供了稳定的固定，骨及软组织血运干扰小，骨折愈合率高，是治疗股骨远端粉碎骨折的首选治疗手段；骨折良好的间接复位及按照LCP固定原则是手术成功的保证.%Abstact] Objective To approach the method and curative effectusing of using LCP to treat distal femur thrypsis by the way of minimally invasive. Methods 2006.6~2011.6, 52 patients of distal femur thrypsis (A3, C), 33 males, 19 female; age 19~75 (average 38.5), using whirbone front-lateral approach, after exact reduction of articular facet, plug in locking steel plate percutem and muscl tunnel, after orperation giving planned rehabilitation. Results all fractures get bone union, average healing time was 18weeks (14~24weeks), 2 cases were superficial infection, 2 cases were deep veins of lower limb thrombosis, no one got internal fixation break and fracture displace again. By Kotmert distal femur functional assessment, excellent 28, good19, common 5, the rate of excellent and good is 90.4%. Conclusion using LCP to treat distal femur thrypsis by the way of micro invasive, can get stable fixation and micro destroy blood supply of bone and soft tissue, the rate of fracture union is high, and it is the frist selection for the treatment of distal femur thrypsis, satisfactory bone fracture indirect reduction and with LCP principle are the pledge of operation success.