轴向牵引下股骨远端骨折闭合复位钢板内固定
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滨州医学院附属医院

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山东省医药卫生科技发展计划(2017WS229);滨州医学院科研计划项目(BY2019KJ31),


Closed reduction and plate fixation for distal femoral fractures via lower extremity axial distractor
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Binzhou Medical University Hospital

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    摘要:

    目的 介绍下肢轴向牵引器闭合复位钢板内固定治疗股骨远端骨折的手术技术及初步临床结果。 方法 2017年07月-2019年06月采用下肢轴向牵引器闭合复位钢板内固定治疗的26例股骨远端骨折患者。A型骨折需先自股骨髁逆行插入钢板而后经钢板安装牵引器牵开复位并固定,C型骨折患者先行复位并固定髁间骨折,逆行插入钢板后安装牵开器进行牵开复位及固定。结果 所有患者均顺利完成手术,无严重并发症发生。随访期间发生膝关节僵硬2例,发生骨折端延迟愈合1例,术后1年根据Schatzker-Lambert标准对患肢功能进行评估:优20例,良5例,优良率96.2%。术后正侧位与术前相比成角畸形明显改善(P<0.05)。结论 下肢轴向牵引器应用于股骨远端骨折闭合复位钢板内固定手术操作方便,能有效提高术中闭合复位效率。

    Abstract:

    [Objective] To introduce the surgical technique and primary clinical outcomes of closed reduction and plate fixation to deal with distal femoral fracture by using the lower extremity axial distractor (LEAD). [Methods] From July 2017 to June 2019, 26 distal femoral fractures with closed reduction by LEAD and internal fixed with plate were reviewed. For type A fracture, the plate should be inserted retrogradely from the femoral condyle, and then the distractor should be installed through the plate to achieve reduction and fixation. For type C fracture, the reduction and fixation of intercondylar fracture should be achieved first and the plate would be inserted retrogradely. The reduction and fixation via LEAD would be processed after that. [Results] All of these patients were completed the operation. No intraoperative or postoperative complications were encountered. Among of them, there were two knee stiffness and one non-union. One years after operation, there were 20 excellent patients and 5 good patients based on the Schatzker-Lambert criteria, the superior rate of them was 96.2%. The comparation of angular deformity based on the preoperative and postoperative images were different significantly (P<0.05). [Conclusion] The LEAD is simple and easy to operate, which can improve the efficiency of closed reduction for distal femoral fracture.

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  • 收稿日期:2020-12-31
  • 最后修改日期:2021-02-28
  • 录用日期:2021-03-23
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