股骨远端锁定钢板治疗老年人股骨远端骨折的疗效分析
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[摘要] 目的：探讨老年人股骨远端锁定钢板治疗股骨远端骨折的临床疗效。方法：回顾性分析我院2006年6月～2009年6月股骨远端骨折的老年患者的基本资料和临床资料，并分为股骨钢板组和拉力螺钉组，并对疗效进行比较。结果：152例患者住院1~2周，平均住院(9.5±1.5)d。按Lysholm评定标准，股骨钢板组优良率为94.74%，拉力螺钉组优良率为77.63%，股骨钢板固定疗效显著优于拉力螺钉内固定(P<0.05)。股骨钢板治疗组复位较好，未见螺钉松动、钢板断裂、骨折移位等并发症，患部疼痛、膝关节屈曲、外展活动受限、切口感染等并发症均低于拉力螺钉组(P<0.05)。结论：股骨锁定钢板治疗老年人股骨远端骨折疗效好，预后康复较快，能较快提高老年患者骨折后的生活质量。
[关键词] 股骨远端骨折；锁定钢板；老年人；疗效
[中图分类号] R683.42[文献标识码]A [文章编号]1673-7210(2011)03(b)-039-02
Clinical efficacy of locking plate in the treatment of distal femoral fractures
CHEN Bin, CAO Hongjie, WANG Changhui
Department of Orthopedics, Yongcheng Coal Group General Hospital in He′nan Province, Yongcheng 476600, China
[Abstract] Objective: To evaluate the efficacy of locking plate on distal femoral fracture for the elderly patients. Methods: Retrospective analysis of basic and clinic datas of distal femoral fracture from June 2006 to June 2009 in our hospital, 152 cases were divided into two groups, locking plate group and lag screw group. Results: The length of stay for 152 cases was 1-2 weeks, average (9.5±1.5) d. The excellent and good rate of locking plate group was 94.74%, and the excellent and good rate of lag screw group was 77.63%, there was a significant difference (P<0.05). The locking plate group for anatomical reduction, pain, flection, limitation of activity and infection were less than those of the lag screw group (P<0.05). Conclusion: The efficacy of locking plate in the treatment of distal femoral fracture are efficiency and can improve the therapeutic effect and quality of life fast.
[Key words] Distal femoral fracture; Locking plate; Elderly; Clinical efficacy
股骨远端骨折是老年人常见的下肢骨骨折，其发生率占所有股骨骨折的4%[1]。由于骨折部位骨结构的特殊性，骨折类型多为粉碎性，因此难以稳定固定，由于骨折部位接近膝关节，常累及到膝关节面，易引起膝关节活动障碍，骨折后常为畸形愈合、不愈合，感染的发生率也较高，是老年人中较为难治的骨折[2]。本文观察了152例老年人股骨远端骨折的患者采用股骨锁定钢板和拉力螺钉不同的内固定方法的疗效比较，现报道如下：
1 资料与方法
1.1 一般资料
选择2006年6月～2009年6月我院共收治股骨远端骨折的老年患者152例，其中，男62例，女90例；年龄最小66岁，最大72岁，平均(66.7±4.6)岁；车祸伤77例，跌伤47例，砸伤28例；左侧53例，右侧99例，均为新鲜损伤，且经X线证实；伤后距离手术时间3 h～7 d，平均(3.2±1.1)d；A型骨折71例(A1型35例，A2型18例，A3型18例)，B型42例(B1型12例，B2型20例，B3型10例)，C型39例(C1型14例，C2型8例，C3型17例)。均无下肢血管、神经损伤。根据内固定类型分为股骨钢板组(76例)与拉力螺钉组(76例)，两组患者在损伤类别、年龄、性别、损伤原因、损伤类型及手术时间等方面差异无统计学意义(P>0 ......
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