摘要
目的探讨单切口闭合复位交锁髓内钉治疗浮膝损伤的疗效.方法回顾2000年3月～2004年3月54例浮膝损伤患者,其中15例采用髌前正中切口,髌韧带内侧入路,C型臂X线机透视下手法整复,胫骨骨折采用扩髓髓内钉固定,股骨逆行髓内钉固定.根据Frasert等骨折分型:Ⅰ型13例,Ⅱb型2例.术后3 d开始CPM功能锻炼.结果术后2、4、6、12个月复查X线片,15例均骨性愈合.术后14周,14例膝关节恢复正常范围,1例活动度达90°,全部患者肢体无短缩、无感染、无断钉.术后随诊5～18个月.疗效评定采用Karlstrom和Olerud标准.优良率为93.3%.结论单切口闭合复位交锁髓内钉固定结合术后CPM功能锻炼治疗浮膝损伤,创伤小、术中出血少、固定可靠、膝关节能早期功能锻炼,可获得满意的疗效.
Objective To investigate the efficacy of closed reduction and interlocked intramedullary nailing through a single approach for floating knee injuries. Methods Fifty- four patients with floating injuries between March 2000 and March 2004 were reviewed. Among them 15 were treated with patellate midline incision, retrograde femoral intramedullary nail and reaming tibial intramedullary nail. According to Frasert classification, 13 cases were of I , 2 cases were ofllb. The continuous passive motion began 3 days after operation. Results The X-ray films of the 15 patients were reviewed after 2, 4, 6 and 12 months of operation respectively. Fourteen patients restored normal movement after 14 weeks. The knee joint could flex to 90 degrees in 1 patient. No shortening, infection or break of nail occurred in all patients. The mean follow- up time was 5- 18 months. The efficacy was assessed according to the criteria of Karlstrom and Olerud. The excellent＇and good results were obtained in 93.3% patients. Conclusion Interlocked intramedullary nailing with closed reduction and single incision with postoperative continuous passive motion provides a satisfied approach to the treatment of floating knee injuries, h has the advantages of fewer invasions, less blood loss, steady fixation and early function recovery.
出处
《中国骨与关节损伤杂志》
2005年第9期586-587,共2页
Chinese Journal of Bone and Joint Injury
