同期与分期交锁髓內钉固定两处骨折治疗“浮膝”疗效观察

Contrast of the Effect on "Floating knee" Treated by Locked Intramedullary Pin to Fix Double Fracture in the Same Stage and in Different Stages

目的:探讨同期与分期交锁髓內钉固定两处骨折治疗“浮膝”的临床疗效差异.方法：对26例患者(均为Fraser分型I型)行同期(A组)与分期(B组)髓內钉固定,其中A组15例,B组11例。术后分别记录两组骨折愈合情况、骨髓炎及脂肪栓塞发生率,并采用Karlstrom等制订的评定标准评定浮膝损伤肢体功能恢复情况。结果:A组创面感染2例,骨折延迟愈合4例,成角1例,短缩1例,骨髓炎2例,脂肪栓塞2例,肢体功能恢复优良率为86.67%;B组创面感染1例,骨折延迟愈合3例,短缩1例,骨髓炎1例,脂肪栓塞4例,肢体功能恢复优良率为63.63%。两组术后并发症差异无统计学意义(P>0.05),肢体功能恢复优良率差异有显著统计学意义(P<0.01)。结论:创伤性“浮膝”损伤患者如病情允许,宜选用同期内固定治疗。

Objective：To investigate the difference of the clinical effect on the treatment of ＂floating knee＂ by the locked intramedullary pin in the same stage and in different stages to fix double fracture. Methods：26 cases （Fraser I） were divided into two groups. 15 cases in group A were dealt with the locked intramedullary pin in the same term to fix. 11 cases in group B were dealt with in the staged. After operation, record respectively the situation of union of fracture and the incidence rate of osteomyelitis and oil embolism. Results： In group A, 2 cases of infection of raw surface, 4 cases of delayed union, 1 case of angulation, 1 case of crispation, 2 cases of osteomyelitis, 2 cases of oil embolism, and the fineness rate of the functional recovery of limbs is 86.67% ; In group B, 1 case of infection of raw surface, 3 cases of delayed union, 1 case of crispation, 1 case of osteomyelitis, 4 cases of oil embolism, and the fineness rate of the functional recovery of limbs is 63.63%. There was no statistically significance in the postoperative complications （P〉0. 05）; There was a statistical significance in the fineness rate of the functional recovery of limbs between them （P〈 0.01）. Conclusion：The results show that internal fixation in same term is the proper treatment for traumatic floating knee.