锁定板微创技术治疗老年人股骨远端骨折的临床效果观察

目的:探讨锁定板MIPO技术治疗老年人股骨远端骨折的临床效果。方法:回顾性分析2009年1月-2012年12月运用锁定板MIPO技术治疗老年人股骨远端骨折患者的临床资料,评估骨折类型、骨折愈合时间、6个月时的膝关节活动度和膝关节功能评分及临床并发症的发生情况。结果:共纳入33例老年人股骨远端骨折患者,平均年龄72岁,其中2例随访失败。87%的股骨远端骨折是关节外骨折;骨折平均愈合时间为12.56(8~29)周;术后6个月时平均活动范围超过105°:伸0°~30°,屈90°~140°;术后6个月的平均膝功能评分89.5;治疗过程中无植入失败、骨折不愈合和感染发生;术后早期发生下肢深静脉血栓(DVT)7例(22.6%),均在膝关节水平以下。结论:锁定板结合MIPO技术是一种治疗老年人股骨远端骨折安全有效的方法,但要注意预防术后DVT的发生。

Clinical Observation on the Therapeutic Effect of Locking Plates with MIPOon the Elderly Patients with Distal Femoral Fractures

Objective:To evaluate the clinical therapeutic effect of locking plates combined with MIPO technique on the elderlypatients with distal femur fractures.Methods:From January 2009 to December 2012, a total of 33 elderly patients (average age 72 years)with distal femur fractures treated by the MIPO technique were reviewed retrospectively. The parameters including classification of fractures, time to fracture union, knee range of motion, knee functional scores (refered to AKS score standard) on 6 months, and other apparent complications were analyzed. Two patients were lost to in the follow-up visit.Results:87% of the fractures were extra articular. Theaverage time to union was 1 2.56 (range: 8-29) weeks. The average range of knee motion achieved at 6 months and beyond was 1 05°ranging from 0 to 30° (extension) to 90 to 1 40° (flexion). Functional knee scores at 6 months from fixation were satisfactory (averagescore 89.5). There was no case of implant failure, nonunion, infection as well. There were 7 (22.6% ) patients developing deep veinthrombosis (DVT) in the early postoperative period, all of which were below the level of the knee joint.Conclusion:Locking plates combined with MIPO techniques was effective and safe in the treatment of the elderly patients with distal femur fractures, but the post operative DVT should receive close attention at the same time.