目的:探讨股骨近端解剖型钢板治疗股骨粗隆间骨折的临床疗效。方法:自2005年1月至2009年1月,采用切开复位,股骨近端解剖型钢板治疗股骨粗隆间骨折46 例。结果: 术后随访6个月～3年,平均18个月,所有病例均在术后3～55个月获得骨性愈合,髋关节功能根据Harris评分标准进行评定,优32 例,良4 例。结论: 股骨近端解剖型钢板适用于治疗大多数类型的股骨粗隆间骨折,能达到良好的骨折复位和坚强的固定,促进关节早期功能锻炼,骨折愈合率高,是治疗股骨粗隆间骨折的理想选择。
ObjectiveTo summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. MethodsBetween January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. ResultsSuperficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. ConclusionAnatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.