| Objective:To retrospectively analyze the clinical efficacy of the treatment of distal femoral fractures with minimally invasive trea- tment of distal femoral fractures with intramedullary nail and ana- tomical plate (MIS), investigating the best surgical treatment of d- istal femoral fractures in patients with clinical surgery.Methods:We choose the patients with lower limb injuries in the Depa rtment of orthopedics, Sichuan provincial hospital from September 2013 to March in were treated with non-other body parts of the 60 cases of patients with closed fracture of the distal femoral fractures. There were 32 males and 28 females, aged from 18 to 60 years old, with an average of 39 years old. Falling injured 12 cases,the traffic accident injuries in 37 cases,11 cases were injured. All patients we re closed fracture. The patients fracture type as winquist typing, type ? 7cases, ? 32 cases,8 cases of type ?. The fractures are unsta-ble fractures, which left fractures in 27 cases,33 cases of fracture of the right side without double-side fracture. All the study subje-cts were fresh fractures, no major organs, nerve vascular injury, basic disease. The time before operation was 3-4 days after injury. According to treatment methods are divided into:the use of minimally invasive intramedullary nail fixation group and the use of anatomical plate MIPPO technology within the fixed group. Two groups were observed after including operative time, blood loss, intraoperative fluoroscopy times, VAS score, fracture after the healing time, postoperative complications (postoperative infection, internal fixation loosening a nd fracture and so on), knee joint dysfunction and other comparative study of indicators.Results:all the 60 cases were followed up for 6-18 months, average 12 months. Comparison of different treatment methods:two treatment group, the average operation time of the treatment group was longer, the average was 103.21±14.56min, the average operative time was 72.08±16.74min. During the operation, the treatment group was less, and the amount of bleeding was less, the amount of bleeding was statistic s:?? intramedullary nail treatment group with an average of 117.47±51.76ml, anatomical plate fixation in the treatment group was 57.67±20.93ml. During the operation, the number of intramedullary nail gr oup was more, the average number of times of perspective statistics:the average number of X-ray was 12±2 times, the average number of the anatomic plate group was 8±2 times. The average operation time, in traoperative blood loss and intraoperative X-ray times were compared between the groups (P<0.05), and the difference was statistically si gnificant. Two groups of surgery in the healing time of fracture, ana tomical plate fixation group of treatment group was 4.51,0.69 months, the treatment group was 0.78 months, no significant difference (P>0.05). The postoperative VAS score, postoperative infection, postoper ative internal fixation loosening or fracture, knee joint dysfunction and other indicators, and two kinds of operation without significant difference (P> 0.05), the difference was not statistically signific ant.Conclusion:antegrade intramedullary nail and plate internal fixation in the middle and distal femoral fracture treatment can meet the clinical requirements, but in the operation time, bleeding volume and clinical perspective on the number, anatomical type plate in the treat ment of superior antegrade intramedullary nail in the treatment of,in fracture healing, postoperative infection, internal fixation loosing and fracture, recovery of function of knee joint on both had no signi ficant difference. |
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