关节镜下交锁髓内钉固定治疗股骨骨折浮膝

Minimally invasive treatment of taumatic floating knee with interlocked intramedullary nailing

目的探讨交锁髓内钉固定微创治疗浮膝的疗效。方法交锁髓内钉固定微创治疗21例浮膝,对于发生于股骨中上段骨折的浮膝,股骨和胫骨髓内钉均顺行打入,选择闭合穿针法;而对于股骨中段以下骨折的浮膝,尤其是对于股骨髁上或伴有股骨髁间骨折的浮膝,采用关节镜下经皮逆行交锁髓内钉固定。关节镜下同时处理膝关节内伴随损伤。结果本组患者全部随访,平均23个月,根据Karlstron膝关节功能评分法评定,优15例,良3例,优良率达85.7%。结论在患者全身状况许可的情况下早期手术,微创完成交锁髓内钉的固定,尽快恢复膝关节两侧力臂的完整性,同时重视膝关节内损伤的早期修复,有利于膝关节功能的恢复,是一种有效的治疗方法。

Objective To study tile effect of minimally invasive treatment of taumatie floating knee with interlocked intramedullary nailing. Methods A total of 21 cases with taumatie floating knee were treated by interlocked intramedullary nailing since January 2002.The treatment of floating knee of middle upper segment of femoral fracture was perfommd with anterograde interlocked intranmdullary naillng;for floating knee of distal segment of femoral fracture using arthroseopieally assisted pereutaneous retrograde inter-locked intrameduIlary nailing,especially for intercondylar or supraeondylar femoral fractures. Results The short-term （23 months） functional recovery was satisfied： excellent in 15 eases; good in 3 cases, thus the rate was 85.7%.Conclusion The management of floating knee with interlocked intramedullary nailing is effective therapy, h has the advantages of less surgleal complications and fast fracture healing. It allows early exercise and recovery of function of the knee joint.