关节镜辅助下股骨远段交锁髓内钉微创取出术

Arthroscopic assisted minimally invasive removal of retrograde interlocking intramedullary nail in distal femur

目的探讨关节镜辅助下股骨远段交锁髓内钉微创取出术比较常规切开手术的优势。方法对我科1998年8月至2010年6月期间收治的31例股骨远段交锁髓内钉固定的患者采用关节镜辅助下交锁髓内钉微创取出术。平均手术时间、创伤大小、恢复时间,以及对膝关节功能影响方面与常规切开手术做了初步比较。结果 31例患者平均手术时间为45min,10d拆线,2周进行日常工作及活动。31例患者均获随访,随访时间6个月至12年,平均18个月,与常规切开手术相比:膝关节伤口小、愈合早、疼痛轻、下地早、膝关节功能均恢复好。结论关节镜辅助下股骨远段交锁髓内钉微创取出术较常规切开手术切口小、创伤小、手术时间短、更安全、功能恢复好,更容易被患者接受。

Objective To investigate the advantages of arthroscopic assisted minimally invasive removal of retrograde intramedullary nails in distal femur compared with conventional surgeries. Methods From August 1998 to June 2010, 31 patients accepted arthroscopic assisted removal of retrograde interlocking intramedullary nail in distal femur. A preliminary comparison was carried out between conventional surgery and minimal invasive surgery on average operation time, wound size, recovery time and the impact on knee function. Results The average operation time of the 31 patients was 45 minutes. Stitches were taken out 10 days after surgery. Patients could return to work and activities 2 weeks after surgery. 31 patients were followed up for an average of 18 months （range; 6 months to 12 years）. Compared with conventional open surgery, minimal invasive surgery had advantages of smaller knee wound, lighter pain, earlier healing and ambulation, and better recovery of knee function. Conclusions Arthroscopy assisted minimal invasive removal of retrograde intramedullary nails in distal femur is more acceptable for patients for its smaller incision, minimal wound, limited operation duration and good recovery.