39例浮膝损伤的治疗

Treatment of Traumatic Floating Knee

目的 探讨浮膝损伤的最佳治疗方法。方法 将 39例浮膝损伤 ,按 Fraser分型方法分为 4型 , 型 11例 , a型 9例 , b型 13例 , c型 6例。所有病人均行手术复位内固定 ,术后早期功能锻炼。结果 34例骨折愈合 ,3例股骨不愈合 ,2例胫骨不愈合 ,经再次植骨内固定后愈合 ,2例胫骨感染 ,经清创、引流、皮瓣转移等而治愈。膝关节功能优良率为 79.5 %。结论 对浮膝损伤的治疗 ,视全身及局部情况选择适当内固定 。

Objective To explore the best treatment of traumati c floating knee. Methods 39 cases of traumatic floating knee were divided into 4 types according to Fraser classification.11 cases were in type Ⅰ,9 cases in type Ⅱa, 13 cases in type Ⅱb, 6 cases in typeⅡc. All patients were received fracture reduction and internal fixation, following early functional training postoperatively. Results Of 39 cases, fractures in 34 cases were obtained healing. Femoral non-union were found in 3 cases, tibial non-union in 2 cases, followed by healing after reoperation with bone graft and internal fixation. 2 cases were affected by tibial infection, and healed after debridement, draining and skin flap transplantation. The rate of execllent and good was 79.5% in terms of restoration of knee joint function. Conclusion Traumatic floating knee should be managed by internal fixation. Interlocking medullary nails are good option.