股骨髁间粉碎性骨折两种术式比较

COMPARISON OF TWO DIFFERENT OPERATIONS ON COMMINUTED INTERCONDYLAR FRACTURE

目的 比较两种不同方法治疗股骨髁间严重粉碎性骨折的疗效。 方法 2 0 0 1年 11月～ 2 0 0 3年10月 ,对 2 0例股骨髁间粉碎性骨折采用两种术式进行治疗。第一组 7例 ,采用闭合复位、经关节镜下定位、小切口置入股骨远端逆行髓内钉固定手术 ;第二组 13例 ,行常规手术切开、直视下复位、逆行髓内钉内固定术。术后行随访观察 ,并进行比较。 结果 术后随访 4～ 2 4个月 ,全部骨折均达到骨性愈合。第一组术后肿胀情况较第二组明显减轻 ,在 6～ 9周内恢复膝关节活动范围达 12 0°,第二组最终仅有 4例达到屈膝 12 0°。 结论 经关节镜置入股骨逆行髓内钉治疗股骨髁间粉碎性骨折具有创伤小、功能恢复好的优点。

Objective To compare the effect of two different operations on treating severely comminuted intercondylar fracture. Methods From December 2001 to October 2003, 20 cases of severely comminuted intercondylar fracture were operated. Of the 20 cases, 7(group 1) were treated with closed reduction and retrograde intramedullary nailing through arthroscope, 13(group 2) were treated with open reduction and retrograde intramedullary nailing without arthroscope. Follow ups were conducted after operation. Results All cases of fracture were recovered. Swelling in group 1 was alleviated more obviously than that in group 2. In group 1, all knees could flex to 120° during 6th to 9th weeks after the operation. In group 2, only 4 could flex 110°. Conclusion Retrograde intramedullary nailing through arthroscope proves to be less invasive and more effective in treating heavily comminuted intercondylar fracture.