DCS及逆行髓内钉治疗股骨远端骨折比较.docVIP

DCS及逆行髓内钉治疗股骨远端骨折比较 　【摘要】 目的 对比应用逆行交锁髓内钉(GSH)和动力髁螺钉(DCS)内固定治疗股骨远端骨折的效果。方法 对2000年8月至2006年2月治疗的54 例股骨远端骨折病例进行对照研究，按AO分类：A1型17 例，A2型14 例，A3型11 例，B1型2 例，C1型6 例，C2型3 例，C3型1 例。其中，DCS内固定30 例，股骨逆行交锁髓内钉固定24 例。分组统计手术时间、出血量、骨折愈合时间、并发症、膝关节功能。结果 所有病例经5个月～2年随防，平均9个月；骨折愈合时间为4.6个月(4～9个月)。DCS固定组平均手术时间1.5 h(1～2.5) h。出血量105 mL(50～200) mL，骨折愈合时间平均4.7月(4～8个月)，并发症发生5 例(发生率16.7％)，根据Kolmert膝关节功能评定，优20 例，良7 例，可3 例，优良率89.6％。GSH固定组手术时间1.8 h(1.5～3.5) h。术中出血量平均120 mL(100～250) mL，平均骨折愈合时间5.1个月(4.5～9个月)，并发症发生5 例(发生率28％)，根据Kolmert膝关节功能评分标准，优15 例，良7 例，可2 例，优良率为91.7％。两组比较，结果无显著差异(P＞0.05)。结论 逆行交锁髓内钉(GSH)及动力髁螺钉(DCS)均是治疗股骨远端骨折的较好方法，但各有其最佳适应证。选择好适应证以及术者技术熟练有利于骨折愈合及关节功能恢复。 【关键词】 股骨远端；交锁髓内钉；动力髁螺钉，内固定，对比 Comparison of DCS and GSH Fixation for the Distal Femur Fractures Abstract：Objective Compare the effect of two treatments for the distal femur fractures with retrograde intramedullary nails (GSH) and dynamic condylar screw (DCS).Methods Study 54 cases patients with distal femur fractures from August 2000 to February 2006.According to AO standard，the cases were assigned：type A1 17，A2 14，A3 11，B1 2，C1 6，C2 3 and C3 1 case.30 cases were treated by DCS and 24 cases by GSH.Recorded the operation time，bleed，union time，complication，function of knee.Results All the cases were followed for 5～24 monthes，mean 9 monthes.mean union time was 4.6 monthes，(4～9 monthes).mean operation time was 1.5 hours(1～2.5 hours)，bleed 105 mL(50～200 mL)，mean union time 4.7 monthes (4～8 monthes)，5 cases suffered complication (rate 16.7％)，According to Kolmert score of knee function.there were excellent 20.good 7 and fair 3，the excellent and good rate was 89.6％ in DCS group.such was 1.8 hours (1.5～3.5)，120 mL (100～250) mL，mean union time 5.1 monthes (4.5～9 monthes).5 cases (rate 20.8％) According to Kolmert score of knee function.There were excellent 15.good 7 and fair 3.The excellent and good rate 91.7％ in GSH group.There was no significant difference between the results of two groups(P＞0.05).Conclusion Retrograde intramedullary nails a