BACKGROUND:There are many reports about clinical effect of femoral fractures with intramedul ary nail and distal femoral fractures with locking plate. However, there is less report about clinical effect of femoral and distal femoral fractures. OBJECTIVE:To investigate the clinical effect of femoral and distal femoral fractures using intramedul ary nail combined with locking plate. METHODEighteen patients with femoral and distal femoral fractures were treated by internal fixation with intramedul ary nail combined with locking plate. Among them, six cases had femoral and supracondylar fractures, seven cases had femoral and condylar fractures, and five cases had femoral and intercondylar fractures. According to the AO classification, three cases were type 33A2, three cases were type 33A3, two cases were type 33B1, five cases were type 33B2, one case was type 33C1, three cases were type 33C2, and one case was type 33C3. The fractures union and complications were fol owed up and observed, and knee joint function was judged by HSS score. RESULTS AND CONCLUSION:Al the 18 patients were fol owed up for 12-24 months. The time for fracture union ranged from 3 to 5 months, average 3.4 months. No infection and disunion, no fracture malunion, no internal fixation loosening and breaking, no refracture happened. The HSS score ranged from 68 to 96 points, average 86.8 points. There were 12 excellent cases, 5 good cases, and 1 common case. The excellent and good rate was 94.4%. The internal fixation using intramedul ary nail combined with locking plate is a good method for treatment of femoral and distal femoral fractures, due to less surgical trauma, simple and reliable fixation, high rate of fracture healing, low rate of complications, and excellent function.%背景：目前应用髓内钉治疗股骨干骨折和应用锁定板治疗股骨远端骨折报道较多，但对股骨干并股骨远端骨折内固定选择报道甚少。 目的：观察髓内钉结合锁定板置入内固定修复股骨干合并股骨远端骨折的临床疗效。 方法：应用髓内钉结合锁定板置入内固定修复股骨干并股骨远端骨折患者18例，其中股骨干骨折合并髁上骨折6例，单髁骨折7例，髁间骨折5例。股骨股骨远端骨折按AO分型：33A2型3例，33A3型3例，33B1型2例，33B2型5例，33C1型1例，33C2型3例，33C3型1例。随访观察患者骨折愈合、并发症发生情况，依据美国特种外科医院(HSS)评分评价膝关节功能恢复情况。 结果与结论：18例患者均获随访，于治疗后3-5个月骨折愈合，平均3.4个月愈合。无感染、切口不愈合、骨折畸形愈合、内固定松动断裂、再骨折发生。HSS评分为68-96分，平均86.8分；其中优12例，良5例，中1例，优良率为94%。提示髓内钉结合锁定板置入内固定修复股骨干并股骨远端骨折，固定简约可靠，创伤较小，骨折愈合率高，并发症少，功能良好。
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