关节镜下逆行交锁髓内钉治疗股骨髁上骨折48例临床治疗观察

Therapeutic effects of retrograde interlocking intramedullary nailing underarthroscopy for supracondylar femoral fractures

目的观察膝关节镜辅助下逆行交锁髓内钉(GSH)内固定术治疗股骨髁上骨折的临床疗效。方法自2007年1月～2011年1月采用膝关节镜辅助下GSH治疗48例股骨髁上骨折病例。其中男性29例,女性19例;年龄21～77岁,平均57岁。闭合性骨折31例,开放性骨折17例;按AO/ASIF分类系统分类:A1型27例,A2型12例,A3型9例。结果 48例随访6～48个月,平均24.6个月。骨折在术后10～18个月内愈合,平均愈合时间14.9个月。术后膝关节功能评价参照Kolmert评分标准,优良率达93.7%。结论膝关节镜辅助下GSH治疗股骨髁上骨折具有创伤小、固定可靠、骨折愈合率高、关节功能恢复良好、并发症少等优点,是一种治疗股骨髁上骨折较理想的方法。

Objective To evaluate the clinical therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on the treatment of supracondylar femoral fractures.Methods From Jan.2007 to Jan.2011,there were 48 supracondylar femoral fractures including 31 closed fractures and 17 open fractures.There were 29 males and 19 femals,and the average age was 57 years ranging from 21 to 77 years.According to the AO/ASIF classification system,27 fractures were evaluated as type A1,12 type A2 and 9 type A3.All the patients were treated by arthroscopically assisted retrograde intramedullary interlocking nails,and were directed to take function exercise after operation.Results Totally 48 cases were followed up for 6-48 months,24.6 months on average.All the fractures were healed on an average of 14.9 weeks postoperatively ranging from 10 to 18 weeks.The functional results of knee joint were assessed according to the Kolmert criteria as excellent in 27,good in 18,fair in 2 and poor in 1.The rate of excellent and good was 93.7%.Conclusion The arthroscopically-assisted retrograde intramedullary interlocking nailing for treating supracondylar femoral fractures has advantages of micro-trauma,firm fixation,high fracture healing rate,good recovery of joint function,few complications.It is an optimal measure for treating supracondylar femoral fractures.