Chen Yu-tao, Yang Jiang-wei, Hou Hai-bin, Wang Chun-sheng, Wang Kun-zheng
Zhongguo Gu Shang. 2015 Feb;28(2):136-40.
To summarize the complications and the early clinical effect of less invasive stabilization system and the femoral condylar support plates in the treatment of AO type C distal femoral fractures.
From September 2007 to February 2012, 46 patients with AO type C distal femoral fractures were retrospectively studied. Of all patients 25 were treated with less invasive stabilization system including 14 males and 11 females with a mean age of (56.3±4.2) years old; according to AO classification, there were 14 cases of C1, 8 cases of C2 and 3 cases of C3 with a mean hospital stay of (15.6±1.7) days. While 21 cases were treated with femoral condylar support plates fixation including 12 males and 9 females with a mean age of (53.8±5.1) years old;there were 13 cases of C1, 6 cases of C2 and 2 cases of C3 with a mean hospital stay of (17.8±2.2) days. Comparative analysis was performed from the operation related index,postoperative complications and Evanich score of the knee joint function between the two groups at follow-up.
All 46 patients were followed up from 13 to 38 months with a mean time of 19.6 months after surgery. Complications included 1 case with infection,3 cases with internal fixation failure, 1 case with nonunion and 1 case with activity limitation of the affected knee. The differences in the incision length, blood loss, fracture healing time were significant between two groups (P<0.05), while there was no significant difference in the duration of operations, hospital stays and the incidence of postoperative complications between two groups (P>0.05). The statistical significance was also found in the Evanich score at last follow-up between two groups (P<0.05).
Patients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time and better functional recovery. Less invasive stabilization system had became one of the ideal internal fixations in the treatment of AO type C distal femoral fractures.
总结微创稳定系统和股骨髁支持钢板治疗AO C型股骨远端骨折的并发症及早期临床疗效。
回顾性分析2007年9月至2012年2月收治的46例AO C型股骨远端骨折患者。其中25例采用微创稳定系统治疗，男14例，女11例，平均年龄（56.3±4.2）岁；按AO分型，C1型14例，C2型8例，C3型3例，平均住院时间（15.6±1.7）天。21例采用股骨髁支持钢板固定，男12例，女9例，平均年龄（53.8±5.1）岁；C1型13例，C2型6例，C3型2例，平均住院时间（17.8±2.2）天。对两组患者的手术相关指标、术后并发症及随访时膝关节功能Evanich评分进行对比分析。
46例患者均获随访，随访时间13～38个月，平均术后19.6个月。并发症包括感染1例、内固定失败3例、骨不连1例、患膝关节活动受限1例。两组切口长度、出血量、骨折愈合时间差异有统计学意义（P<0.05），而手术时间、住院时间及术后并发症发生率差异无统计学意义（P>0.05）。两组末次随访时Evanich评分差异有统计学意义（P<0.05）。
微创稳定系统固定治疗患者创伤小、骨折愈合时间短、功能恢复好。微创稳定系统已成为治疗AO C型股骨远端骨折的理想内固定方式之一。
