股骨髁间骨折术后膝关节僵硬的常见原因分析

Cause analysis of knee joint stiffness after operation of femur intercondylar fracture

目的探讨股骨髁间骨折术后膝关节僵硬的常见原因。方法回顾性分析导致23例股骨髁间骨折术后膝关节僵硬的主要因素。结果在回顾分析的23病例中,均有不同程度的膝关节僵硬,按照Merchan的评分标准,可18例,差5例。究其主要原因,不恰当的手术入路20例,术中未予关节囊重建19例,内固定选择不当10例,内固定松动断裂4例,外固定时间过长4例。结论股骨髁间骨折术后易出现膝关节僵硬,为力求避免出现这种情况,应选择适合的手术入路,术中应尽量重建关节囊并充分引流,选择恰当的内固定物,保护下进行早期功能锻炼。

Objective To explore the possible causes resulting in stiffness in knee joint post-operation of femur intercondylar fracture.Methods Twenty-three cases dignosed as knee joint stiffness were retrospectively analyzed and possible causes were discussed.Results According to Merchan＇ knee function score system,there were 18 fair and 5 poor.Operation approaches in 20 cases were regarded improper,knee joint capsules were eligibly not reconstructed in 19 cases;unfit choice of internal fixation materials emerged in 10 cases,plates and scrows for inernal fixation were broken in 4 cases,and overtime external fixation was applied in 4 cases.Conclusion Knee joint stiffness after operation of femur intercondylar fracture occurred easily.In order to avoid it proper operating approach and internal fixation materials were important.Knee joint capsule needed to be reconstructed.Postoperative drainage and early function exercise should actively be done.