股骨下段粉碎性骨折合并腘动脉损伤手术疗效观察

Surgical treatment of comminuted fractures of the lower femur complicated with popliteal artery injury

目的探讨手术治疗股骨下段粉碎骨折合并腘动脉损伤的疗效。方法12例股骨下段粉碎骨折合并腘动脉损伤患者先采用复位骨折后安置逆行交锁髓内钉,然后更换体位修补或吻合腘动脉。结果本组患者平均随访11个月（6--18月）,患肢均存活并获骨性愈合,无感染、内固定断裂、畸形愈合及再骨折发生。膝关节手术患者评分表（KSS）平均为89分：优9例,良3例;2例膝关节少量积液;全部患者膝关节无内外翻畸形,主动伸展受限小于20°。结论股骨下段粉碎骨折合并腘动脉损伤积极手术治疗可获得满意临床疗效。逆行交锁髓内针可获满意固定效果。

Objectives To discuss the curative effects of comminuted fractures of the lower femur complicated with popliteal artery injury. Methods A total 12 patients suffering comminuted fractures of the lower femur with popliteal artery injury accepted fixation by retrograde interlocking nails and the repair or anastomosis of the popliteal artery. The clinical results were observed. Results All patients received a follow - up period of 11 months （ 6 - 18 months）. None of the patients had the break of the nail, malunion, refractures, genua varums or genua valgums. All cases achieved bone union. Slight effusion of the knee joint occurred in 2 cases. The limited ranges of active motion of the joint were below 20 degrees. According to KSS scale, the average score was 89 points, with good in 9 cases, fire in 2 cases. Conclusion In the treatment of comminuted fractures of the lower femur with popliteal artery injury, retrograde interlocking nails has the advantages of shorter operative time and stable fixation.