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[股骨远端骨折。两种不同手术治疗方法的对比分析]

[Distal femur fractures. Comparative analysis of two different surgical treatments].

作者信息

Valles J F, Rodríguez F R, Gómez J M

机构信息

Hospital Español de México.

出版信息

Acta Ortop Mex. 2010 Sep-Oct;24(5):324-30.

Abstract

INTRODUCTION

The treatment of distal femur fractures has been a controversial topic and it has recently evolved towards indirect reduction and minimally invasive techniques.

OBJECTIVE

To compare the results of the surgical treatment of distal femur fractures with a plate with screws for condylar compression purposes with the minimally invasive stabilization system.

MATERIAL AND METHODS

Patients with distal femur fractures treated surgically between January 2007 and December 2009 were assessed retrospectively. The following variables were registered from each patient record: age, sex, type of fracture, mechanism of injury, type of implant used, operative time and postoperative bleeding. The Neer scale was used to compare the anatomical, radiologic and functional results of both techniques.

RESULTS

The total number of patients was 52; 32 males and 20 females; mean age was 58 years. A plate with screws was used in 31 patients for condylar compression purposes, and a minimally invasive stabilization system in 21. The cases managed with a minimally invasive stabilization system had a shorter operative time and less intraoperative bleeding. The results of the evaluation using the Neer scale were similar for both modalities.

CONCLUSIONS

The patients with fracture of the distal third of the femur managed with a minimally invasive stabilization system had better outcomes, which were not significant in the Neer scale, mainly due to less pain intensity, early mobilization and less functional repercussions.

摘要

引言

股骨远端骨折的治疗一直是一个有争议的话题,最近已朝着间接复位和微创技术发展。

目的

比较用于髁部加压的带螺钉钢板手术治疗股骨远端骨折与微创稳定系统的治疗结果。

材料与方法

回顾性评估2007年1月至2009年12月期间接受手术治疗的股骨远端骨折患者。从每位患者的病历中记录以下变量:年龄、性别、骨折类型、损伤机制、所用植入物类型、手术时间和术后出血情况。使用Neer评分量表比较两种技术的解剖学、影像学和功能结果。

结果

患者总数为52例;男性32例,女性20例;平均年龄为58岁。31例患者使用带螺钉钢板进行髁部加压,21例使用微创稳定系统。采用微创稳定系统治疗的病例手术时间较短,术中出血较少。两种方式使用Neer评分量表的评估结果相似。

结论

采用微创稳定系统治疗的股骨远端三分之一骨折患者有更好的预后,在Neer评分量表中差异不显著,主要是因为疼痛强度较小、能早期活动且功能影响较小。

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