股骨髁部粉碎骨折的手术治疗

Operative Treatment of the Comminuted Fractures of Femoral Condyle

目的：股骨髁部粉碎骨折保守治疗常是畸形愈合、关节强直。因骨折严重粉碎、骨缺损、皮肤损伤等手术治疗常很困难。作者于１９８８～１９９５年手术治疗５１例。材料与方法：本组男４５例，女６例。术中先将前后髁及内外髁固定，然后将髁部和股骨干固定。主要用预弯的梯型钢板加螺栓等。结果：解剖复位４４例，经二期膝关节功能恢复后屈曲＞７０°者８４．４％。结论：本组治疗方法适于股骨髁部粉碎骨折，术后应早期功能练习，但对严重粉碎者不能强求，可于将来取钢板同时行伸膝装置粘连松解。对合并多处骨折者，在做好充分准备的情况下可同时手术内固定。

Malunion and stiff joint may be caused with the conservative treatment in the comminuted fracture of the femoral condyle, and also the operation may be quite difficult due to the severe comminuted fracture, bone defect and skin injury. The authors reviewed 51 cases with comminuted fractures of the femoral condyle from 1988 to 1955. There were 45 males and 6 females. The treatment was firstly to fix the condyle fracture and then the condyle parts and the femoral trunk mainly with bending ladder shape plate and screwbolts. The results were satisfactory. 44 cases got anatomical reduction and the flexion reached more than 70° for 84.4 percent of the patients after restoration of the knee joint function in the second stage. The treatment is suitable for those comminuted fractures of femoral condyle. Early exercises are necessary except for those severe cmminuted fractures. They can be given an releasing of extension mechanism while removing out the plate. The internal fixations can be carried out at the same time for those with multiple fractures where all are well prepared.