目的评估前侧入路锁定钢板内固定治疗股骨远端C型骨折的疗效。方法2009年1月至2012年7月在我院治疗的股骨远端C型骨折共34例，男20例，女14例，年龄17~62岁，平均33岁，开放性骨折11例，合并髌骨骨折4例，脑出血1例，无神经、血管损伤。从手术时间、术中出血量、膝关节功能恢复满意率等方面评价治疗效果。结果33例完成随访，1例失去随访，随访时间5~47个月，平均19个月；手术时间65~145min，平均97min；术中出血量150~450mL，平均220mL；膝关节功能满意率达87.9%。结论前侧入路锁定钢板内固定术是一种治疗股骨远端C型骨折的有效方法，具有提供早期关节功能锻炼、恢复关节功能等优点，明显改善患者的生活质量。%Objective To evaluate the treatment outcome of type C3 fractures (supracondylar and intercondylar fractures) treated with opening reduction internal ifxation with locking compression plate (LCP) using the anterior approach. Methods A total of 34 patients (male 20 and female 14) with type C3 fractures underwent surgical repair between January 2009 and July 2012 in our hospital. The average age was 33 years old (range, 17-62 years). Among the patients, 11 were open fracture. Patients also had associated injuries, including 4 patellar fractures, cerebral hemorrhage (n=1), but no one injured nerve or vascular. The data, including operating time, blood loss, and the rate of satisfactory result of knee function were collected for clinical analysis. Results All of 34 patients had adequate follow-up except 1 patient. The mean of follow-up period was 19 months (5-47 months). The duration of the operation was 65 to 145 minutes with an average of 97 minutes. Blood loss was 150-450 mL with an average of 220 mL. Assessment of functional result (using Neer’s scoring criteria) revealed 29 cases with good or satisfactory outcome, and 4 cases with poor or unsatisfactory outcome. The rate of good or satisfactory result was 87.9%. Conclusion Open reduction internal ifxation with locking compression plate using the anterior approach appears a suitable treatment for type C3 fractures. The surgical repair can signiifcantly improve the life quality of patients with recovering joint function under early joint functional training.
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