逆行交锁髓内钉联合骨卡环置入内固定治疗股骨髁上骨折

Green Seligson Henry nails plus memory clutching internal fixator for the treatment of supracondylar femoral fractures

背景:逆行交锁髓内钉联合记忆合金骨卡环置入内固定治疗股骨髁上A型骨折,固定稳定有利于骨折愈合,可早期锻炼。目的:探讨逆行交锁髓内钉联合记忆合金骨卡环置入内固定治疗股骨远端骨折的临床疗效。方法:纳入患者19例。根据AO分型:33A1型11例,33A2型6例,33A3型2例。其中男12例,女7例:年龄17-68岁,平均37.2岁。全部患者均通过逆行交锁髓内钉联合记忆合金骨卡环置入内固定治疗。结果与结论:17例患者获得随访4-24个月(平均8个月),骨折临床愈合时间12-18周,平均愈合时间14周;无内固定物松动、断裂及畸形、关节感染、骨不连等发生,术后发生切口表浅感染2例,膝关节滑膜炎2例,原有骨性关节炎一过性加重1例。按HSS膝关节临床功能评定,优12例,良3例,优良率88%,可2例(12%)。说明采用逆行交锁髓内钉联合记忆合金骨卡环置入内固定治疗股骨髁上A型骨折生物力学稳定,能有效恢复股骨髁上骨折的稳定性及完整性,固定可靠,能促进骨折愈合,有利于早期进行功能锻炼。

BACKGROUND： The technique of internal fixation for type A supracondylar femoral fractures with combination of Green Seligson Henry nails and memory clutching internal fixator have many advantages of strong biomechanical fixation, improvement of fracture union and early exercises. OBJECTIVE： To investigate the clinical effects of Green Seligson Henry nail plus memory clutching internal fixator for the treatment of type A supracondylar femoral fractures. METHODS： Nineteen cases of type A supracondylar femoral fractures were treated with Green Seligson Henry nails plus memory clutching internal fixator. There were 11 cases of type 33A1,6 cases of type 33A2 and 2 cases of type 33A3 according to AO/ASIF classification. The demography of the 19 cases was as follows： 12 males and 7 females, ranging from 17 to 68 years old （a mean of 37.2 years old）. All cases were treated with Green Seligson Henry nails plus memory clutching internal fixator. RESULTS AND CONCLUSION： Seventeen out of 19 cases were followed-up with a mean period of 8 months （4 to 24 months） The time for fracture union averaged 14 weeks （12-18 weeks）. No implant loosening or breaking, knee joint infection, deformity and nonunion were observed. Two cases of infected incision, 2 cases of postoperative traumatic arthrits,1 cases of temporary aggravation of pre-existing osteoarthritis were documented as postoperative complication. For the 17 cases, 12 cases score excellent under the HSS score, 3 good and 2 average （12%）. The excellent and good rate was 88%. Internal fixator with combination of Green Seligson Henry nail and memory clutching has better characteristics of stability mechanism in treating type A supracondylar femoral fractures. The stability and integrity of type A supracondylar femoral fractures can be recovered. This method has many advantages such as stable fixation, improvement of fracture union and early exercises.