关节镜下微创逆行髓内钉治疗股骨髁上骨折

Arthroscopically Assisted Treatment of Femoral Supracondylar NonunionFracture with Retrograde Interlocking Intramedullary Nail

目的评价关节镜下微创逆行髓内钉治疗股骨髁上骨折不愈合的疗效。方法 2003年10月至2008年7月行关节镜下微创逆行髓内钉治疗不愈合的股骨髁上骨折12例,均行自体髂骨植骨。结果随访8~64个月（平均32.4个月）,12例骨折术后复位良好,临床愈合时间6个月,功能满意。HSS评分,优10例,良1例,中1例,优良率91.67%。结论较之于传统内固定及LISS,关节镜下逆行髓内钉治疗不愈合的股骨髁上骨折创伤小,骨折端血运破坏小,愈合率高,恢复快,可显著改善膝关节功能,疗效满意。

Objective To evaluate clinical outcomes of arthroscopically assisted treatment of femoral supracondylar nonunion-fracture with retrograde interlocking intramedullary nail.Methods Between October 2003 and July 2008,12 cases of nonunion-fractures received arthroscopical treatment with retrograde interlocking intramedullary nail.Auto-bone grafting was performed.Results The average follow-up was 32.4 months from 8 to 64 months.All cases were operated successfully with anatomical reduction and stable internal fixation,and achieved solid bone union at an average of 6 months.Function was satisfied,According to HSS Rating system,excellent results were obtained in 10 cases,good in 1case,fair in 1case.Conclusion Satisfied function can be obtained with arthroscopical treatment of femoral supracondylar nonunion-fracture,and this technique was characterized by minimal invasion,fast fracture healing,sound joint function and worths further clinical application.