微创稳定系统与解剖钢板内固定治疗股骨远端骨折的对比观察

摘要

Objective To compare the clinical efficacy of less invasive stabilization system (LISS) and anatomical plating in the treatment of distal femoral fracture. Methods 90 patients with distal femoral fracture were randomly divided into invasive group (45 patients, received LISS) and anatomical plating group (45 patients, received anatomical plating), the operation time, perioperative blood of two groups were compared, union of fractures were checked by X-ray after surgery, HSS was applied to observe functional recovery of knee joint and clinical efficacy, and the complications of the two groups were also observed. Results The operation time of invasive group was shorter than that of anatomical plating group (t = 2.88, P < 0.05), and perioperative blood was less than the latter (t = 6.73, P < 0.01), perioperative autoallergic flank bone graft was less than that of anatomical plating group (χ2 = 11.40, P < 0.01). No statistical difference in union of fracture time was observed between the two groups (t = 1.16, P > 0.05), but the HSS of invasive group after 12 months was significantly higher than that of anatomical plating group if = 2.99, P < 0.05). The good rate of clinical efficacy in invasive group was statistically higher than that in anatomical plating group (χ2 = 5.20, P < 0.05). The incidence of complications in invasive group and anatomical plating group was 11.11% and 26.67% respectively, they showed statistical difference (χ2 = 7.60, P < 0.05). Conclusion Compared with anatomical plating, LISS can shorten operation time, decrease surgery injury and blood, induce the requirement of bone graft and obtain better clinical efficacy and less complication, thus it is worthy of extensive applied in clinic.%目的 比较微创稳定系统与解剖钢板内固定治疗股骨远端骨折的临床效果.方法 将90例股骨远端骨折患者随机分为微创组(45例,采用微创稳定系统治疗)和解剖钢板内固定组(45例,采用解剖钢板内固定治疗),比较两组手术时间、术中出血量,术后复查X线观察两组骨折愈合情况,采用膝关节功能评分(HSS)观察功能恢复情况、临床疗效、术后并发症.结果 微创组患者手术时间较解剖钢板内固定组短(t = 2.88,P ＜ 0.05),术中出血量较解剖钢板内固定组少(t = 6.73,P ＜ 0.01),术中行自体髂骨植骨者较解剖钢板内固定组少(χ2 = 11.40,P ＜ 0.01).两组骨折愈合时间差异无统计学意义(t = 1.16,P ＞ 0.05);术后12个月,微创组HSS评分显著高于解剖钢板内固定组(t = 2.99,P ＜ 0.05).微创组疗效优良率显著高于解剖钢板内固定组(χ2 = 5.20,P ＜ 0.05).微创组并发症发生率(11.11%)较解剖钢板内固定组(26.67%)低(χ2 = 7.60,P ＜ 0.05).结论微创稳定系统较解剖钢板内固定治疗股骨远端骨折可缩短手术时间,减少手术损伤及出血,降低植骨需要,疗效好,并发症少,值得临床推广使用.