顺行髓内钉、逆行髓内钉及锁定加压钢板内固定治疗股骨远端骨折的对比研究

摘要目的：探讨顺行髓内钉、逆行髓内钉及锁定加压钢板内固定3种方法治疗股骨远端骨折患者的疗效。方法：对2011年1月至2012年12月间我院收治的101例股骨远端骨折进行临床随机分组手术，分别在手术中使用顺行髓内钉、逆行髓内钉以及锁定加压钢板内固定。对三组患者手术时间、术中出血量以及切口长度等一般情况进行比较分析，同时采用Harris评分系统对三组患者术后恢复情况进行分析比较。结果：经过手术治疗后，逆行髓内钉组Harris评分显著高于其他两组（P〈0．05）。另外，逆行髓内钉组手术过程短、出血量少、手术切口小，上述指标与其他两组比较均有统计学意义（P〈0．05）。结论：股骨远端骨折行逆行髓内钉治疗的疗效优于顺行髓内钉以及锁定加压钢板内固定，具有手术时间短、术中出血少、切口小等优点，能够有效提高术后膝关节功能的恢复，值得临床推广使用。

The Comparative Study on Anterograde Intramedullary Nail, Retrograde Intramedullary Nail and Locking Compression Plate Fixation in the Treatment of Distal Femoral Fractures

Objective： To investigate the curative effect of anterograde intramedullary nailing, retrograde intramedullary nail, and locking compression plate fixation methods for distal femoral fractures patients. Methods： 101 cases with distal femoral fxactures t~om January 2011 to December 2012 in our hospital were randomized and given clinical surgery, and used anterograde intramedullary nailing, retrograde intramedullary nail and locking compression plate fixation in surgery, respectively. Comparative analysis the general of three groups in the operation time, intraoperative blood loss, length of incision and so on. At the same time, Harris scoring system was adopted for three groups of patients with postoperative recovery. Results： After surgery, Harris score of retrograde intramedullary nail group was significantly higher than that of the other two groups （P〈0.05）. In addition, retrograde intrameduUary nail group procedure was short, less blood loss, small incision, the above indicators have statistical significance compared with those in other two groups （P〈0.05）. Conclusions： The curative effect of distal femoral fracture with line retrograde intramedullary nailing treatment is better than that of anterograde intramedullary nail and locking compression plate fixation, with shorter operation time, intraoperative bleeding, and the advantages of small incision, less ability to improve the postoperative knee function recovery, and is worthy of clinical use.