罗艺 王卢林 杨益山

[摘要] 目的 探讨股骨远端骨折患者采取AO微创内固定系统治疗的效果。 方法 选取2015年3月～2016年4月在我院收治的78例股骨远端骨折患者，随机分为两组，各39例。对照组给予传统解剖鋼固定治疗，观察组给予AO微创内固定系统治疗，观察并对比两组临床效果。 结果 观察组手术时间、术中出血量和住院时间均显著低于对照组（P<0.05）。术后随访24个月，观察组骨折愈合时间和膝关节活动度显著优于对照组（P<0.05）；观察组HSS评分优良率为92.31%，明显高于对照组的74.36%（P<0.05）；观察组的并发症发生率（5.13%）显著低于对照组（20.51%）（P<0.05）。 结论 对于股骨远端骨折采取AO微创内固定系统，手术伤口小，患者康复较快，可降低术后并发症，值得在临床中应用。

[关键词] 股骨远端骨折；AO微创内固定系统；应用效果；HSS评分；并发症

[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2018）25-0095-03

[Abstract] Objective To investigate the effect of AO minimally invasive internal fixation system in patients with distal femoral fractures. Methods A total of 78 patients with distal femoral fracture treated in our hospital from March 2015 to April 2016 were randomly divided into 2 groups， with 39 cases in each group. The control group was treated with traditional anatomical steel fixation. The observation group was treated with AO minimally invasive internal fixation system. The clinical effects of the two groups were observed and compared. Results The operative time， intraoperative blood loss and length of stay in the observation group was significantly lower than that in the control group （P<0.05）. In the follow-up for 24 months after operation， fracture healing time and knee joint activity in the observation group was significantly better than that of the control group（P<0.05）.The HSS score excellent and good rate of the observation group was 92.31%， significantly higher than the control group 74.36%（P<0.05）. The incidence of complications in the observation group （5.13%） was significantly lower than that in the control group（20.51%） （P<0.05）. Conclusion AO minimally invasive internal fixation system used for distal femoral fractures makes surgical wound small and patient fast recovery. It can reduce the postoperative complications and is worthy of clinical application.

[Key words] Distal femoral fracture； AO minimally invasive internal fixation system； Application effect； HSS score； Complication

股骨远端骨折是指股骨下端距膝关节面5 cm以内的骨折，多为高速高能量损伤，常伴有严重的软组织损伤。由于其临床解剖结构复杂，且临近关节面，复位和固定难度较高，极易发生畸形愈合、关节僵直、伤口感染等并发症[1]。目前股骨远端骨折的手术和固定方法较多，不同方法对患者的手术疗效和临床预后存在差异。AO微创内固定系统（Less invasive stabilization systems，LISS）是一种基于AO/ASIF微创外科原则的内固定系统[2]。本研究选择我院收治的78例股骨远端关节骨折，分别采取AO微创内固定系统和传统解剖钢固定治疗，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年3月～2016年4月在我院收治的股骨远端骨折患者78例。其中男48例，女30例，年龄21～50岁，所有患者均符合西医《实用骨科学》[3]的诊断标准，并经X射线片确诊为股骨远端骨折。纳入标准：均为新鲜闭合性骨折；精神状态良好；对本研究知情并签署同意书。排除标准：合并他处严重骨折者；心力衰竭等严重脏器衰竭患者。根据手术方式将符合条件的78例患者随机分为两组各39例。……