闭合正骨复位经皮穿钉外固定架治疗股骨髁上骨折观察

Observation on Supracondylar Fracture of Femur Treated by Boneset Replacement throughout External Fixation with Leather Nail

目的 :探讨股骨髁上骨折的手术治疗方法及疗效。方法 :闭合正骨复位、半罗纹钉经皮穿入股骨、Bastiani外固定架固定术治疗 2 6例 ;切开复位 L型钢板内固定术治疗 8例 ,加压钢板骨栓内固定术治疗 4例。结果 :骨折全部愈合 38例 ,其中 2 6例接受外固定架治疗者 ,4 6～ 5 8天骨折愈合拆除外固定架 ,膝关节功能优 2 2例 ,良 4例 ,可 0例 ,差 0例 ,12例钢板内固定术治疗者 ,术后 6周解除石膏外固定 ,锻炼膝关节伸曲功能活动 ,18个月后手术取出内固定钢板 ,膝关节功能优 6例 ,良 4例 ,可 2例 ,差 0例。结论 :闭合正复经皮穿钉 Bastiani外固定架固定术创伤轻微 ,固定可靠 ,术后早期进行患肢功能锻炼。骨折愈合 ,膝关节功能恢复 ,均明显优于钢板内固定术。避免了切开复位内固定二次手术医源性创伤和石膏外固定的并发症以及繁重的术后护理工作。

Objective:To investigate the operation treatment of the Supracondylar fracture of femur and to analyses its dinkum effects Method:The bonestting of traditional Chinese medicine conservative the nail half screw thread is cat into the femur percutaneous there are 26 cases cured by using the Bastiani External fixation apparatus,of which 8 cases are through operations in which femur is replanted and fixed,with L-shape steel board,and 4 cases are treated by adding and pressing steel board into Bone-bolt.Results:38patients'fractures all healed26 patients who had The outer fixed-stands were removed 46 or 58 days after operations.of all these cases 22cases are excellent,4 cases are good and there is no unsuccessful cases;the patients who had steel board to fix with had the gypsum released and began to practise the knee point 6 weeks after operations and in the 18 th month the fixed steel boards were removed in operation.of all these cases,6cases are excellent,4 cases are good and 2cases are OK;Conclusions:the fixed method in which the femur is replanted and the screw thread half nail is cut into the femur through the skin and the Bastinis outer fixed-stand is used causes little wound and can fix the femur tightly Early after operations the patients practise the hurt legs The degrees of healed fractures and recovery of the knee joint are better than the fixed methed using the steel board.This method can avoid conventional surgical repeated wound and complications caused by fixed gypsurn and the tedious nursing work after operations. [