36例股骨髁上粉碎性骨折手术疗效观察

Effective observation on surgical treatment in 36 patients with femoral supracongylar comminated fractures

目的观察股骨髁上粉碎性骨折手术疗效。方法36例全部行手术切开复位＋加压钢板＋松质骨螺丝钉内固定术，其中植骨3例。结果36例均骨性愈合。随访时间2～6年，平均2．5年，其中1例开放伤口迟缓性感染合并骨髓炎，4例并发膝关节僵硬，经二期手术治疗后，治愈。钢板取出时间为12～26个月，平均18个月。根据hohl对膝关节功能评分评定治疗效果（包括膝关节伸直程度、活动度、内外翻角度，行走距离及疼痛程度），其中优18例（占50％），良12例（占33．33％），中5例（占13．89％），差1例（占2．78％）。结论股骨髁上粉碎性骨折及早手术疗效优良，有效地防止了病人肢体的伤残。

Objective To observe the effects of surgical treatment of femoral supracondylar comminuted fracture （FSCF）. Methods Open reduction surgery compression plate, cancellous bone screw fixation were used to treat 36 patients with FSCF, of them, three patients received bone grafting. Results Bone healing occurred in 36 patients. follow-up period ranged from 2 to 6 years, with an average of 2.5 years. Slow infection of open wounds with osteomyelitis occurred in one patients, Four patients complicated by stiffness of knee joint were cured by the secondary operation. Plate removal time ranged from 12 to 26 months, with an average of 18 months. The effective value was performed in accordance with the knee function score hohl of therapeutic effect evaluation, including the degree of knee extension, activity, angles of internal and external turnover, walking distance and pain. Result showed excellent occurred in 18 patients （50%）, good in 12 patients （33.33%）, moderate in five patients（ 13.89% ）, poor in one patients （2.78%）. Conclusion Effects of the early surgical treatment for the femoral supracondylar comminuted fractures are excellent and can effectively prevent and cure the limb disability of the patients.