The Effect Of Retrograde Intramedullary Nailing And Locking Plate Fixation On The Treatment Of A Type A Fracture Of Femoral Condyle

Objective : By collecting retrograde intramedullary nail and locking plate internal fixation on the treatment of femoral condyle fracture operation time(min),type A intraoperatie blood loss(ml),decreased postoperative hemoglobin level(g/l),incision length(cm),the length of time(day)(week),fracture healing time,postoperative follow-up of knee function(point),and the incidence of complications in comparison and statistical analysis,evaluation of retrograde intramedullary nail and locking plate internal fixation treatment on type A femoral condyle fracture curative effect.Methods:A total of 32 patients with type A fracture of the femoral condyle with upper femoral condylar were collected and treated in the second hospital of Dalian Medical university from October 2015 to March 2017.Diagnostic criteria:(1)medical history:there is a clear history of trauma in the distal part of the femur;(2)check: the distal pressure of the femur and the axial strike pain(+),while touching the bone rubbing and bone friction of the distal part of the femur;(3)auxiliary examination: X-ray films indicated the discontinuity of the distal bone cortex of the femur,and further CT three-dimensional reconstruction of the specific fractal and displacement degree of distal fracture of the femur.Inclusion criteria:(1)age is greater than 16;(2)unilateral condylar fractures of the femoral condyle;(3)the lateral limb was functioning normally before the injury;(4)intramedullary intramedullary nail or internal fixation of steel plates to treat fracture of the femoral condyle;(5)after the operation,the limb function should be exercised strictly according to the doctor’s advice.(6)continuous follow-up for 3 months and above.Exclusion criteria:(1)fracture is old,pathological and open fracture;(2)patients with complex trauma;(3)previous history of distal femoral surgery;(4)accompanied by severe nerve and vascular injury;(5)patients with severe heart,brain,liver,lung,kidney and other organic diseases and coagulant dysfunction can not tolerate surgery;(6)patients who can not cooperate with treatment,compliance and no follow-up.Will conform to the standard of 32 patients with fracture of femoral condyle on type A(retrograde intramedullary nail)were randomly divided into experimental group and control group(locking plate),and identify the two groups of patients with gender,age,cause of injury and fractures AO classification comparison difference has no statistical significance(P > 0.05),the patient’s operation time(min),intraoperative blood loss(ml),decreased postoperative hemoglobin level(g/l),incision length(cm),the length of time(day)(week),fracture healing time,postoperative follow-up of knee function(point),and the incidence of complications through statistics and contrast analysis,2 weeks,6 weeks after surgery,2,3,6 months and 1 yearfollow-up time,according to the clinical physical examination and imaging examination record accurately fracture healing time and complications,and postoperative 1 year using HSS knee score evaluation of knee joint function.Results:All 32 patients received adequate follow-up time,with an average follow-up time of 11.8(8-14).Statistics of 32 cases of patients with operation time(min),intraoperative blood loss(ml),decreased postoperative hemoglobin level(g/l),incision length(cm),the length of time(day)(week),fracture healing time,postoperative follow-up of knee function(point),and the incidence of complications and comparison,the retrograde intramedullary nailing group of operation time,intraoperative blood loss,incision length,length of hospital stay and locking plate internal fixation group is obviously better than the fracture healing time(p < 0.05),only in the degree of postoperative hemoglobin decreased slightly worse than locking plate group(p < 0.05),but the difference in the knee joint function and complication rates and no significant difference(p > 0.05).Conclusions:The study compared the retrograde intramedullary nail and locking plate internal fixation on the treatment of femoral condyle fracture type A curative effect of two kinds of surgical method can achieve satisfactory results,both in terms of knee joint function and complication rates,there is no significant difference,but the retrograde intramedullary nailing group of operation time,intraoperative blood loss,incision length,length of hospital stay and locking plate internal fixation group is obviously better than the fracture healing time,only in the degree of postoperative hemoglobin decreased slightly worse than locking plate group,but the centricity intramedullary nail fixed way closer to the human body normal biomechanics of lower extremities.Therefore consider from all aspects,we in the face of the femoral condyle on type A fractures,should be the preferred retrograde intramedullary nail,but the scope of application of locking plate with intramedullary nailing is more extensive,and its application in the clinical history is more long nails,technology is more mature,which makes us in clinical actually choosing surgery for the patient,should be combined with the patient and all aspects of the treatment condition at that time,select the best operation scheme to get the most satisfactory therapeutic effect.