自制撑开复位器与关节镜治疗股骨髁上骨折的运用

The Curative Effect of Closed Reduction by Self-designed Tractor and Arthroscopic for Retrograde Intramedully Interlocking Nail(RIIN) for Femoral Supracndylar Fracture

目的:应用自行研制的撑开复位器闭合复位、关节镜引导穿入股骨髁上钉治疗股骨髁上骨折,并与切开复位治疗比较。方法:股骨髁上、髁间骨折90例,其中应用撑开复位器闭合复位关节镜下逆行交锁钉治疗50例(A组),切开复位逆行交锁钉治疗40例(B组)。结果:A组手术时间、术中出血、切口长度、骨折愈合时间均明显少于B组。按Merchan评分标准:A组:优32例,良12例,可6例,差0例,B组:优14例,良16例,可7例,差3例。两组疗效优良率无统计学差异。结论:应用自制撑开复位器、闭合复位关节镜下逆行交锁钉手术时间短、出血少、切口短、骨折愈合快有利于膝关节功能的恢复。

Objective：The curative effect of closed reduction by self-designed tractor and arthrosropic for retrogradein amedul lary interlocking nails in the treatment of femoral supracondylar fracture,Methods：A total of 90 patients withfemoral fractures underwent either closed arthroscopic（n=50） oropen surgeries（n=40）.Results：The operation time.surgical bloodloss and bone union time in closed arthroscopic groups was lessthan that in the open surgery group.（P〈0.01）. Folow-up of thepat ients for 12-19months revealed excellent results in 32cases,good 12 cases,and fair 6 cases,poor 0 in the arthoscopicgroup,according to the Merchan eriteria.while excellent in 14 cases,good 16 cases,and fair 7 cases,poor 3 in the open surgerygroup,without statistically significances in the rate of excellent or good Outcomes be tween the two groups.Conclusion：Compared with open surgery RIIN shortens the operationtime.incision length,reduces in ,traoperative blood loss andaccelerats bone union,thus benefiting,the recovery of knee joint functions.