浮膝损伤内固定治疗的比较

Comparison of surgical internal fixation methods for floating knee injury

目的总结46例创伤性浮膝手术的治疗经验，探讨创伤性浮膝的有效治疗方法及功能恢复情况。方法回顾性分析我院自2002年4月至2007年1月共收治的46例浮膝损伤患者的治疗及预后情况。治疗方法为两处骨折均一次性完成内固定手术，手术分为交锁髓内钉内固定组（A组）、交锁髓内钉＋钢板内固定组（B组）及钢板内固定组（C组），将三组的疗效及预后进行分析评价。结果对46例患者经6～60个月（平均12个月）随访，参照Karlstrom和Olerud评定标准对三组内固定方式的总体疗效进行判定，A组优良率94％，B组优良率86％，C组优良率73％，交锁髓内钉内固定治疗组疗效明显优于钢板内固定组（P〈0．05）。结论创伤性浮膝在治疗中选择交锁髓内钉内固定治疗是内固定手术疗效较为满意的方法。

Objective To sum up the experiences of the traumatic floating knee in 46 cases in our hospital and to explore the therapeutic methods of the traumatic floating knee. Methods With the retrospective investigation of the treatment and recovery in 46 cases of traumatic floating knee from April 2002 to January 2007 in our hospital. According to different therapeutic effect and recovery conditions, all cases were devided into three groups：locked intramedullary nail group,locked intramedullary nail plus internal steel plate fixation group and internal steel plate fixation treatment group. Results After the follow up time - average for 12 months （from 6 to 60 months）. According to the Karl- storm＇s and Olerud＇ s classification, the excellent rate of locked intramedullary nail group was 94%. The rate of locked intramedullary nail plus internal steel plate fixation group was 86%. The rate of internal steel plate fixation treatment group was 73%. The efficacy of locked intramedullary nail was better than that of internal steel plate fixation treatment group（ P 〈0.05）. Conclusions Locked intramedullary nail is the most comfortable methods in the therapy of traumatic floating knee among these three groups.