创伤性浮膝伴血管损伤的早期诊治

Early Diagnosis and Treatment of Traumatic Floating Knee with Vascular Injuries

目的探讨创伤性浮膝同时伴同侧血管损伤患者的早期诊断及救治.方法总结1996年6月～2002年12月收治28例30个浮膝的手术固定方法、血管修复情况及术后治疗和恢复情况.结果术后伤口一期愈合5例,17例伤口二期行植皮修复,4例胫前骨折部外露二期行皮瓣转移术,截肢2例,保肢成功率92.9%.术后26例经18个月～8年随访,骨折均愈合,下肢功能恢复优良率64.3%.结论对浮膝损伤患者应高度重视伴有血管损伤可能,早期作出诊断,积极合理治疗,对患者预后至关重要.

Objective To diagnose and treat traumatic floating knee with ipsilateral vascular injuries at early stage. Methods Twentyeight cases （30 knees） of traumatic floating knee with ipsilateral vascular injuries from Jun 1996 to Dec 2002 were analyzed retrospectively. Results There were 5 primary healing, 17 secondary healing after skin graft and 4 skin flap graft in which anterior tibia were exposed. Two patients were treated by amputation. The patients were followed up for 18-96 months, 26 of them healed. The good or excellent rate of lower limb function was 64.3 %. Conclusion The possibility of vascular injury should be considered in the treatment of traumatic floating knee. Early diagnosis and positive reasonable surgical treatment play great roles in the prognosis of the disease.