摘要
目的探讨髌外侧入路与股前外侧入路分别联合微创稳定系统(LISS)钢板治疗对C型股骨远端骨折的临床疗效。方法我院行LISS钢板治疗的96例C型股骨远端骨折患者,将采取髌外侧入路的48例患者作为A组,采取股前外侧入路的48例患者作为B组。比较两组手术指标(手术时间、术中出血量、术中透视次数、住院时间、骨折愈合时间)、疗效、膝关节功能(Evanich评分)、术后并发症发生率等。结果 A组手术时间短于B组,术中出血量、透视次数少于B组,治疗优良率高于B组(P <0. 05),两组住院时间、骨折愈合时间、术后并发症发生率及疼痛、稳定性评分比较,差异无统计学意义(P>0. 05),A组活动度、股四头肌力量、减分项目评分及总分均高于B组(P <0. 05)。结论与股前外侧入路联合LISS钢板治疗C型股骨远端骨折比较,选择髌外侧入路可减少手术损伤,缩短手术时间,且对患者膝关节功能改善效果更好,疗效更佳,但两种入路方式造成的并发症发生率无显著差异。
To observe the clinical efficacy of the lateral patellar approach or anteriolateral femoral approach combined with less invasive stabilization system(LISS)plate in the treatment of C-type distal femoral fractures.The clinical data of 96 patients with C-type distal femoral fractures treated by LISS plate in our hospital were retrospectively analyzed.According to the different surgical approaches,48 cases with lateral patellar approach were selected as group A,and 48 cases with anterolateral femoral approach were selected as group B.The surgical indexes such as operative time,intraoperative blood loss,number of intraoperative fluoroscopy,hospital stay,fracture healing time,efficacy,knee joint function(Evanich score)and postoperative complications were compared between the two groups.The operative time,intraoperative blood loss,number of fluoroscopy and rate of excellent and good treatment in the group A were shorter or less or higher than those in the group B(P<0.05).There was no statistically significant difference in the hospital stay,fracture healing time and incidence rate of postoperative complications as well as the scores of pain and stability between the two groups(P>0.05).The range of motion,quadriceps muscle strength and scores and total score of reduction items in the group A were higher than those in the group B(P<0.05).Compared to the anterolateral femoral approach,the lateral patellar approach can reduce the surgical injury and shorten the operative time for C-type distal femoral fractures.The lateral patellar approach also has better effects on the improvement of knee joint function and better efficacy.Nevertheless,there was no significant difference in the incidence rate of complications caused by the two approaches.
作者
韦玮
卢显威
黄林海
兰敏东
黄绍东
WEI Wei;LU Xian-wei;HUANG Lin-hai;LAN Min-dong;HUANG Shao-dong(Department of Orthopaedics,Wuming Hospital,Guangxi Medical University,Nanning 530199,China)
出处
《实用医院临床杂志》
2018年第6期160-163,共4页
Practical Journal of Clinical Medicine
关键词
髌外侧入路
股前外侧入路
LISS钢板
C型股骨远端骨折
Lateral patellar approach
Anterolateral femoral approach
LISS plate
C-type distal femoral fractures
