切开复位内固定治疗股骨髁冠状面骨折疗效分析

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1、切开复位内固定治疗股骨髁冠状面骨折疗效分析作者：张海波，张世清，赵金廷【摘要】［目的］探讨切开复位、松质骨拉力螺钉内固定治疗股骨髁冠状面骨折的方法及临床疗效。［方法］1998年5月～2006年6月，通过前外(内)侧或后外(内)侧入路，行切开复位、松质骨拉力螺钉内固定术治疗股骨髁冠状面骨折17例，其中男15例，女2例；年龄19～48岁，平均39.5岁。按Letenneur分型：Ⅰ型7例，Ⅱ型4例，Ⅲ型6例。闭合性骨折14例，开放性骨折3例。采用自体髂骨或同种异体骨植骨共5例。术后均行石膏外固定。受伤至手术时间平均3.6d(2.5h～8d)。［结果］所

2、有患者术后获8～26个月(平均18.2个月)随访，骨折均获骨性愈合，骨折愈合时间平均为3.6个月。膝关节功能参照Letenneur评估标准，优良14例，可3例，无差者。本组无深部感染、内固定松动和骨坏死。［结论］切开复位、松质骨拉力螺钉内固定治疗股骨髁冠状面骨折是一种安全、有效的治疗方法。正确选择手术入路、满意的复位和骨折端坚强稳定的内固定对疗效具有决定作用。【关键词】Hoffa骨折；股骨髁；骨折内固定术；切开复位9Abstract：［Objective］Todiscussthemethodandclinicaleffectsofcoronalfr

3、acturesofthefemoralcondyletreatedwithopenreductionpluscancellouslagscrewinternalfixation.［Method］FromMay1998toJune2006,17casesofcoronalfracturesoffemoralcondyleweretreatedwithopenreduction'andcancellouslagscrewinternalfixationbyusinganterolateralfortypⅠortypⅢlateralfemoralcond

4、ylarfracture(LFCF)/anteromedialfortypeⅠortypeⅢmedialfemoralcondylarfracture(MFCF)orposterolateralfortypeⅡLFCF/posteromedialapproachfortypeⅡMFCF.Therewere15malesand2femaleswiththeaverageage39.5years,rangingfrom19to48years.AccordingtoLetenneurclassification,thereweretypeⅠfractur

5、e7cases,typeⅡ4cases,andtypeⅢ6cases.Amongthem,14caseswereclosedfracture,3easeswereopenfracture.Autoiliumtransplantorhomologousallograftbonetransplant(5cases)werealsoused.Allpatientsweretreatedwithplasterexternalfixationafteroperation.Theintervalbetweeninjuryandsurgeryaveraged3.

6、6days(2.5hoursto8days).［Result］Allpatientswerefollowedupfor8～26monthswithanaverageof18.2months.Allfracturesgotboneunionwithaverageuniontime3.6months.KneejointfunctionwasratedbasedonLetenneurevaluationsystemandshowedexcellenand9goodin14cases,finein3casesandnopoor.Therewerenodee

7、pinfection,implantfailureorbonenecrosis.［Conclusion］Openreductionpluscancellouslagscrewinternalfixationisanideallysafeandeffectiveoperationtotreatcoronalfracturesofthefemoralcondyle.Accuratechoiceofapproach,satisfactoryreductionandrigidinternalfixationhaveimportantinfluenceonc

8、linicaloutcomes.Keywords：Hoffafracture;femoralcondyle;interna