CAJ | 학술논문

目的：探讨应用微创内固定系统（LISS）与股骨髁支持钢板治疗股骨远端C型骨折的并发症和早期临床效果疗效差异。方法回顾性分析46例行内固定的股骨远端C型骨折患者，其中25例行微创内固定系统内固定（LISS组），21例行股骨髁支持钢板内固定（髁钢板组），从手术相关指标、术后并发症及患侧膝关节功能评分对2种治疗方法进行比较分析。结果与髁钢板组相比，LISS组切口长度短，术中出血量少，骨折愈合所需时间短（P＜0.05），2组手术时间、住院时间比较差异无统计学意义。LISS组内固定断裂1例。髁钢板组内固定松动、断裂各1例，术后4周发生感染1例，骨折不愈合1例，因患膝关节活动度降低行膝关节镜下松解术1例。LISS组Evanich评分总分为（90.6±3.3）分，高于髁钢板组的（81.2±1.8）分。结论 LISS是治疗股骨远端C型骨折的理想内固定方式。
목적：탐토응용미창내고정계통（LISS）여고골과지지강판치료고골원단C형골절적병발증화조기림상효과료효차이。방법회고성분석46례행내고정적고골원단C형골절환자，기중25례행미창내고정계통내고정（LISS조），21례행고골과지지강판내고정（과강판조），종수술상관지표、술후병발증급환측슬관절공능평분대2충치료방법진행비교분석。결과여과강판조상비，LISS조절구장도단，술중출혈량소，골절유합소수시간단（P＜0.05），2조수술시간、주원시간비교차이무통계학의의。LISS조내고정단렬1례。과강판조내고정송동、단렬각1례，술후4주발생감염1례，골절불유합1례，인환슬관절활동도강저행슬관절경하송해술1례。LISS조Evanich평분총분위（90.6±3.3）분，고우과강판조적（81.2±1.8）분。결론 LISS시치료고골원단C형골절적이상내고정방식。
Objective To summarize complications and early clinical effect of less invasive stabilization system and the femoral condylar support plates in treatment of AO type C distal femoral fractures. Methods We reviewed 46 patients who had internal fixation of AO type C distal femoral fractures. Of all 46 patients, 25 were with less invasive stabilization sys-tem and 21 were with femoral condylar support plates fixation. Comparative analysis was performed using intraoperative in-dex, postoperative complications and the Evanich score at follow-up. Results All 46 patients were followed up with a mean time of 19.6 months after surgery. The difference in incision length, blood loss, fracture healing time was significant between the 2 groups(P<0.05)but not in the duration of operations and hospital stays(P>0.05). The statistical signifi-cance was also found in the total incidence of postoperative complications and the Evanich score at the last follow-up(P<0.05). Conclusion Patients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time, less postoperative complications and better functional recovery compared with femoral condylar sup-port plates. Less invasive stabilization system had became an ideal internal fixation in treatment of AO type C distal femoral fractures.