摘要
目的探讨老年脊髓灰质炎后遗症患者股骨远端骨折的治疗。方法2008年5月至2012年12月，采用微创内固定系统（LISS）治疗老年脊髓灰质炎后遗症患者股骨远端骨折9例，其中男3例，女6例，平均年龄62．7±6．1（56~75）岁。手术采用微创切口，间接复位（关节内骨折除外），仅对1例再骨折且开放复位患者进行植骨。术后给予抗骨质疏松药物辅助治疗。结果平均手术时间为127±41（80-180）min，术中平均失血198±164（50-600）ml，输血1例；术后患者平均住院4．3±1．2（3～7）d。术后随访16±11（6～42）个月显示，骨折愈合时间为4．1±1．3（3～7）个月，末次随访时患肢膝关节活动度为107°±13°（90°～125°），美国特种外科医院（HSS）膝关节功能评分为73±7（63-86）分，无切口感染及再骨折等并发症发生。结论采用uSS治疗老年脊髓灰质炎后遗症患者股骨远端骨折可获得良好疗效，有助于保护骨膜及骨折部位血运，对疏松骨质把持力好，固定牢靠，利于骨折愈合与功能恢复。药物辅助治疗对促进老年人骨愈合、改善骨质量、预防再次骨折也至关重要。
Objective To explore the treatment of distal femoral fractures in elderly patients with post poliomyelitis. Methods From May 2008 to December 2012, the less invasive stabilization system （LISS） was used in treating the distal femur fractures of 9 elderly patients with post poliomyelitis. There were 3 males and 6 females, with an average age of 62. 7 ± 6. 1 years （range, 56-75 years）. The LISS plates were inserted through a small incision after closed reduction （except the intra-articular fractures）. Only one re-fracture patient underwent the bone graft who accepted the open reduction and internal fixation. Anti -osteoporosis drug therapy was provided for all patients after operations. Results The average operation time was 127 ± 41 rain （range, 80-180 min） while the average blood loss was 198 ± 164 ml （range, 50-600 rnl）, one case received a blood transfusion. All patients were discharged from hospital about 4. 3 ± 1.2 days （range, 3-7 days） after operation. The average follow up period was 16 ± 11 months （6-42 months）. Bone unions were observed 4. 1 ± 1.3 months （range, 3 7 months） after operation. At the end of the follow-up period, the range of motion of the knees on affected side was 107°± 13° （range, 90°- 125°） and the Hospital for Spedal Surgery （HSS） knee score was 73 ±7 （range, 63-86）. Complications like infection and re-fracture were not observed. Conclusions LISS aided in achieving a better construct stability of osteoporotic fractures and provided good outcomes for distal femoral fractures in elderly patients with post poliomyelitis with less damage on periosteum and blood supply at fracture sites, and lessincidence of complications. At the same time, anti ostcoporosis drug therapy for promoting bone healing, improving bone quality and preventing the re-fracture, is also important.
出处
《国际骨科学杂志》
2013年第6期445-448,共4页
International Journal of Orthopaedics
