摘要
目的探讨逆行髓内钉固定治疗全膝关节置换术后股骨髁上骨折的手术方法及临床疗效。方法采用回顾性病例描述研究分析。2012年2月-2016年8月四川大学华西医院骨科、成都市第二人民医院骨科应用髓内钉逆行固定全膝关节置换术后KimⅠB型股骨髁上骨折40例,男性25例,女性15例;年龄37~76岁,平均60.5岁。记录术中出血量、手术时间、骨折愈合时间、并发症,随访Neer评分、VAS评分。结果手术时间40~70min,平均52.1min;术中出血量30~105mL,平均65.5mL;骨折全部愈合,愈合时间17~33周,平均20.8周。无内固定松动、断裂,骨髓炎不良情况。40例均完成随访,随访时间13~35个月,平均20.6个月;Neer评分平均85.2分。40例患者中非常满意10例,满意24例,不满意6例,总满意率为85.0%(34/40)。患者术后2周VAS评分平均32.1分,功能25.3分,运动18.3分,解剖重建8.8分;术后2年VAS评分平均77.1分。结论股骨逆行髓内钉治疗全膝关节置换术后KimⅠB型股骨髁上骨折疗效确切,创伤小,恢复快,值得临床推广。
Objective To investigate the surgical method and clinical effect of retrograde intramedullary nailing in the treatment of femoral supracondylar fracture after total knee replacement.Methods From Feb. 2012 to Aug. 2016,40 patients with KimⅠB femoral supracondylar fracture after total knee replacement were treated with intramedullary nail retrograde fixation.There were 25 males and 15 females with an average age of 60.5(37-76) years. The amount of bleeding,operation time,fracture healing time and complications were recorded.Neer score and VAS score were followed up.Results The average operation time was 52.1(40-70) minutes.The average bleeding time was 65.5(30-105) mL.The fracture healed completely.The average healing time was 20.8(17-33) weeks.There was no loosening or rupture of internal fixation or adverse osteomyelitis.Forty patients were followed up for average of 20.6(13-35) months.Neer score averaged(85.2±11.5)points.There were 10 cases of excellent and good,18 cases of satisfactory and 6 cases of unsatisfactory without failed case. The total satisfaction rate was 85.00%(34/40).The average score of pain,function,movement and anatomical reconstruction was 32.1,25.3,18.3, 8.8,respectively.The average VAS score was 77.1 at 2 years after operation.Conclusion Retrograde intramedullary nail is effective in treating KimⅠB supracondylar fracture of femur after total knee arthroplasty, which has advantages of minimal trauma and rapid recovery, and is worthy of clinical promotion.
作者
颜宇
蒋华
曾勇
马红兵
徐兵
王俊瑞
蒋电明
刘晓艳
YAN Yu;JIANG Hua;ZENG Yong;MA Hong-bing;XU Bing;WANG Jun-rui;JIANG Dian-ming;LIU Xiao-yan(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610016,China;Department of Orthopaedics,Chengdu Second People s Hospital,Chengdu 610016,China;Department of Orthopedics,Third Affiliated Hospital,Chongqing Medical University,Chongqing 401220,China)
出处
《创伤外科杂志》
2020年第2期101-104,共4页
Journal of Traumatic Surgery
基金
四川省中医药管理局课题(2014F041)
关键词
股骨髁上骨折
全膝关节置换术
髓内钉
supracondylar fracture of femur
total knee replacement
intramedullary nail
