手术治疗浮膝损伤52例

Operation on 52 cases of the floating knee

目的探讨手术治疗浮膝损伤的意义。方法根据不同骨折部位采用不同内固定器械及外固定治疗浮膝损伤５２例，其中３４例胫骨、３８例股骨切开复位内固定，１８例胫骨、１４例股骨用外固定支架固定。结果４５例经６个月～４年（平均１５年）随访，优３０例，良５例，中４例，差６例。优良率８３３％。结论早期手术固定有利于严重多发伤的治疗和骨与关节功能恢复，开放性骨折一期内固定的前提是有效彻底清创；早期应用外固定器治疗浮膝损伤可减少出血性休克、脂肪栓塞等并发症，并具有操作简单、固定牢固、手术损伤小、感染率低等优点。

Objective To investigate the significance of surgery of the floating knee. Methods Different parts of the fracture were treated in 52 cases with different internal fixation and external skeletal fixation. 72 fractures were treated with open reduction and internal fixation(34 tibias, 38 femurs). 18 tibial fractures and 14 femoral fractures were given external brace fixation. Results 45 cases were followed up for 6 months to 4 years with an average of 15 years. The results in 30 cases were excellent, 5 cases showed good results, 4 cases fair and 6 cases poor results. The rate of excellent and good results accounted for 833%. Conclusion Early fixation has advantage to the treatment of severe multiple bone and joint injuries and restoration of the function. For open fractures stage I internal fixation should be performed after complete and timely debridement.In the treatment of the floating knee,immediate use of external fixation can reduce the complication of hemorrhagic shock and fat embolism. It has the advantages of simpler manipulation, rigid fixation, less blood loss and lower infection rate.