【摘要】 选择2005-08/2007-08天津市海河医院骨科和天津骨科医院创伤科收治的复杂性膝关节周围骨折92例,其中传统内固定组38例,Liss内固定组54例。传统内固定组应用动力髁螺钉、解剖型钢板、T型钢板治疗;Liss内固定组应用微创Liss系统治疗。内固定后4周内1次/周随访,4周后1次/月,检查膝关节主动活动范围,摄X射线片,观察断端对位对线及骨痂生长情况。采用美国特种外科医院膝关节功能评分法进行膝关节功能评估,满分为100分。两组患者均得到随访,无感染、延迟愈合、断钉、断钢板等并发症。传统内固定组中30例国际内固定研究学会A型骨折患者平均膝关节屈曲度为95°,8例C型骨折患者平均膝关节屈曲度为80°。8例延迟愈合,骨折平均愈合时间为12.5个月,所有患者内固定后对位对线满意。Liss内固定组中44例国际内固定研究学会A型骨折患者平均膝关节屈曲为117°,10例C型骨折患者平均膝关节屈曲度为110°。骨折平均愈合2.5个月,所有患者内固定后对线满意,有8例成角畸形。Liss内固定组患者的疗效优良率高于传统内固定组(96.3%,76.3%,P<0.05)。与传统内固定系统相比,微创Liss内固定系统具有创伤小,骨折愈合快,固定牢靠,可早期功能锻炼等优点,治疗效果优于传统内固定。更多还原

【Abstract】 From August 2005 to August 2007,92 patients with complex fractures around the knee were selected from Department of Orthopedics,Tianjin Haihe Hospital and Department of Traumatology,Tianjin Orthopedics Hospital,including 38 undergoing traditional fixation and 54 undergoing Liss internal fixation.The traditional fixation group was fixed with dynamic condylar screw,anatomic plate,and T-plate;Liss system was used for treatment of Liss internal fixation group.The patients were followed up once a week since 4 weeks following fixation,and once a month after 4 weeks to examine active range of motion of the knee.X-ray was taken to observe callus formation.HSS system was used to evaluate knee function with 100 scores as full marks.All patients were followed up,during which no infection,delayed union,screw or plate breakage occurred.Based on AO classification,in traditional fixation group,30 cases of type A showed joint range of flexion 95°,and 8 of type C showed 80°.Eight cases developed delayed healing.The mean healing time was 12.5 months,and all patients were satisfactory to the contraposition.Based on AO classification,in Liss fixation group,44 cases of type A showed joint range of flexion 117°,and 10 of type C showed 110°.The mean fracture healing duration was 2.5 months.Eight patients developed angulation deformity.The excellent and good rate of Liss fixation group was significantly greater than traditional fixation group(96.3%,76.3%,P < 0.05).Compared with traditional fixation system,minimally invasive Liss fixation system exhibits advantages of rapid healing,reliable fixation,and early functional exercise.Moreover,the treatment effect is superior over traditional method.更多还原