CAJ | 학술논문

目的对比微创稳定系统(LISS)和解剖钢板治疗股骨远端复杂骨折的临床效果.方法 2002年7月至2007年12月,应用LISS及解剖钢板治疗股骨远端复杂骨折42例.解剖钢板组23例,男16例,女7例;年龄21～63岁,平均39.9岁;骨折按AO/OTA分型:A2型3例,A3型7例,C2型12例,C3型1例.LISS钢板组19例,男11例,女8例;年龄20～59岁,平均40.5岁;骨折按AO/OTA分型:A2型2例,A3型6例,C2型10例,C3型1例.比较两组手术时间、手术切口、出血量、是否植骨、术后并发症及愈合时间等,用改良HSS评分来评价术后膝关节功能的改善程度.结果术后解剖钢板组随访12～18个月,平均13.7个月;USS钢板组随访12～18个月,平均13.8个月.所有患者切口均一期愈合.放射学愈合时间及术后并发症发生总数两组比较差异无统计学意义.解剖钢板组的植骨例数多于LISS钢板组.手术时间、手术切口、出血量及HSS评分比较,LISS钢板组优于解剖钢板组,但USS钢板组钢板刺激症状有增高的趋势.结论 LISS及解剖钢板治疗股骨远端复杂骨折均可取得满意效果,但LISS固定系统具备角度稳定性,骨折固定可靠,体现微创原则,是治疗股骨远端复杂骨折的新趋势.
목적 대비미창은정계통(LISS)화해부강판치료고골원단복잡골절적림상효과.방법 2002년7월지2007년12월,응용LISS급해부강판치료고골원단복잡골절42례.해부강판조23례,남16례,녀7례;년령21～63세,평균39.9세;골절안AO/OTA분형:A2형3례,A3형7례,C2형12례,C3형1례.LISS강판조19례,남11례,녀8례;년령20～59세,평균40.5세;골절안AO/OTA분형:A2형2례,A3형6례,C2형10례,C3형1례.비교량조수술시간、수술절구、출혈량、시부식골、술후병발증급유합시간등,용개량HSS평분래평개술후슬관절공능적개선정도.결과 술후해부강판조수방12～18개월,평균13.7개월;USS강판조수방12～18개월,평균13.8개월.소유환자절구균일기유합.방사학유합시간급술후병발증발생총수량조비교차이무통계학의의.해부강판조적식골례수다우LISS강판조.수술시간、수술절구、출혈량급HSS평분비교,LISS강판조우우해부강판조,단USS강판조강판자격증상유증고적추세.결론 LISS급해부강판치료고골원단복잡골절균가취득만의효과,단LISS고정계통구비각도은정성,골절고정가고,체현미창원칙,시치료고골원단복잡골절적신추세.
Objective To conclude the clinic outcomes of the treatment of the complicated distal femoral fractures with less invasive stabilization system (LISS) and anatomical plate. Methods From July 2002 to December 2007, 42 patients with complicated distal femoral fractures were treated with LISS or anatomical plate (16 males, 7 females, with the average age of 39.9 years). AO/OTA types were involved with A2, A3, C2, and C3. The patients in LISS group were treated with locked plate (LISS), and the patients in anatomical plates group were reduced via the incision and treated with anatomical plates. All patients were followed for 12 to 18 months. Outcomes were assessed by recording the surgical experience, post-operative complications and improvements of knee function as measured by the modified HSS score. Results For all patients, there were no differences in the mechanisms of injury, fracture type, mean age, gender distribution between the two groups. The surgical time, wound size and blood loss were significandy less in the LISS group than those in the anatomical plate group. The bone graft was used more frequently in the anatomical plate group. Overall post-operative complications, bony union rate or radiographic healing times were all similar in both groups. A significantly higher incidence of post-operative loss of reduction was observed in the anatomical plate group. A trend toward significance of a higher incidence of symptomatic hardware irritation was observed in the LISS group compared to the anatomical plate group. Conclusion LISS and the anatom-ical plate both obtain the satisfactory outcomes in our study. Less invasive stabilization system has angel stability,and is a safe and effective for complicated fractures of distal femoral fractures. LISS provides an alternative treatment for the complicated distal femoral fractures, and is new trend.