CAJ | 학술논문

目的探讨解剖型锁定钢板治疗股骨远端骨折术后膝关节功能恢复的影响因素。方法2008年7月~2013年7月，收治85例股骨远端骨折患者。骨折根据Mül er分型：A型22例，B型11例，C型52例。受伤至手术时间为7~21d，平均10d。内固定统一采用解剖型锁定钢板。术后膝关节功能采用HSS评分标准评定，并对年龄、性别、受伤侧别、骨折分型、受伤至手术时间、手术时间、复位质量、是否植骨、开始功能锻炼时间、对疼痛耐受程度、住院时间跨度、是否输血、是否行CPM功能锻炼、术后并发症14个因素对股骨远端骨折术后膝关节功能恢复的影响进行统计学分析。结果术后80例切口Ⅰ期愈合；术后1w 5例切口感染，给予清创换药、或人工皮覆盖后愈合。85例均获随访，随访时间18~36个月，平均24.5个月。骨折于术后4~8个月获临床愈合。术后出现伸膝装置粘连、活动度<80o26例，创伤性关节炎22例，膝轻度内翻或外翻9例，固定物松动2例。膝关节功能按照HSS评分：优51例，良16例，可10例，差8例，优良率为78.82%。结论股骨远端骨折术后，年龄、骨折分型、复位质量、对疼痛耐受程度、是否行CPM功能锻炼、术后并发症因素均可明显影响膝关节功能恢复。术前调整患者的身体状态，使骨折解剖复位，并牢固固定，术后早期主动、被动功能锻炼，减少术后并发症，以便最大程度恢复膝关节功能。
목적탐토해부형쇄정강판치료고골원단골절술후슬관절공능회복적영향인소。방법2008년7월~2013년7월，수치85례고골원단골절환자。골절근거Mül er분형：A형22례，B형11례，C형52례。수상지수술시간위7~21d，평균10d。내고정통일채용해부형쇄정강판。술후슬관절공능채용HSS평분표준평정，병대년령、성별、수상측별、골절분형、수상지수술시간、수술시간、복위질량、시부식골、개시공능단련시간、대동통내수정도、주원시간과도、시부수혈、시부행CPM공능단련、술후병발증14개인소대고골원단골절술후슬관절공능회복적영향진행통계학분석。결과술후80례절구Ⅰ기유합；술후1w 5례절구감염，급여청창환약、혹인공피복개후유합。85례균획수방，수방시간18~36개월，평균24.5개월。골절우술후4~8개월획림상유합。술후출현신슬장치점련、활동도<80o26례，창상성관절염22례，슬경도내번혹외번9례，고정물송동2례。슬관절공능안조HSS평분：우51례，량16례，가10례，차8례，우량솔위78.82%。결론고골원단골절술후，년령、골절분형、복위질량、대동통내수정도、시부행CPM공능단련、술후병발증인소균가명현영향슬관절공능회복。술전조정환자적신체상태，사골절해부복위，병뢰고고정，술후조기주동、피동공능단련，감소술후병발증，이편최대정도회복슬관절공능。
Objective To explore the factors af ecting the recovery of knee joint function of anatomical locking plate in the treatment of distal femur fracture after operation.Methods In July 2008~In July 2013,85 patients with distal femoral fractures.According to Mül er classification:type A 22 cases,type B 11 cases,type C in 52 cases.The time from injury to surgery for 7~21 days,average 10 days.Internal fixation with anatomical locking plate uniform.HSS score was used to evaluate the knee function after surgery,and the age,gender,injury side,type of fracture,time from injury to operation,operation time,quality of reduction,bone grafting and functional exercise time,on pain tolerance degree,hospitalization time span,blood transfusion,whether or not CPM functional exercise,operation the 14 factors of complications after statistical analysis on the ef ect of functional recovery of knee joint after the distal femur fractures are fractures.Results After operation,80 cases were healed;after 1 weeks post operative incision infection in 5 cases,given debridement healing dressing,or artificial leather covered.85 cases were fol owed up for 18~36 months,average 24.5 months.On the 4 postoperative~8 months for the clinical fracture healing.Knee extensor device adhesion and activity of&lt after operation;80 degrees in 26 cases,22cases of traumatic arthritis of knee varus or valgus,mild in 9 cases,2 cases of prosthetic loosening.According to HSS knee function score:excel ent in 51 cases,good in 16 cases,10 cases and poor in 8 cases,the excel ent and good rate was 78.82%.Conclusion The distal femoral fracture after operation,age,type,quality of reduction, on whether the pain tolerance,CPM functional training,postoperative complications factors may af ect the recovery of function of knee joint fracture.The patient's preoperative physical status adjustment,the anatomical reduction of the fracture,and firm fixation,early postoperative active and passive functional exercise,reduce the postoperative complications and to maximize the recovery of function of knee joint.