Ⅱ型漂浮膝损伤的治疗

Type Ⅱ floating knee:the experience of treatment

目的 探讨Ⅱ型漂浮膝损伤的手术治疗方法，并观察其疗效。方法 总结42例Ⅱ型漂浮膝损伤患者的临床资料，对其中41例42个下肢采取手术治疗并选用合适固定方式，股骨单骨固定1例，胫骨股骨同时固定41个下肢。结果 随访36例，时间5个月-7年，平均15个月，膝关节活动度平均为95°，总优良率为30．6％。结论Ⅱ型漂浮膝损伤由于累及到关节，关节功能预后较差，但仍应积极手术对同侧胫骨股骨予以坚强固定，待骨干稳定后行关节功能锻炼和处理关节内损伤。

Objective To explore the operational methods of type Ⅱ floating knee injuries, and to observe the efficacy. Methods The clinic data of 42 consecutive ipsilateral fractures of femur and tibia with intraarticular extension into the knee （TypeⅡ ） was reviewed, in which 42 limbs of 41 cases were treated by operation. Femur was fixed singly in one case,and both femur and tibia were fixed simultaneous by internal or external fixators in other 41 limbs. Resuits The mean follow-up time was 15 months（5 months -7 years）. The follow-up of 36 cases showed that the average range of motion of the knee was 95 degrees ,and 30. 6% excellent and good results were obtained in total cases. Conclusions Due to involving with the knee joint in type Ⅱ floating knee injuries, the prognosis of joint function is not so good. Rigid fixation for femur and tibia through operation should be performed. Only by doing this, the aim for rehabilitation and mobilization of the injured legs and treatment for injuried ligments can be obtained.