同侧股骨干、胫骨多段骨折的治疗

Treatment of multi-segmental fractures of ipsilateral femur and tibial shaft

目的同侧股骨干、胫骨多段骨折固定的意义。方法本组32例分别采用加压钢板、带锁髓内钉、单边外固定架固定。结果随访6个月～3年,骨折愈合,肢体功能恢复参照HSS计分方法,优25例,占80.6%;良4例,占12.9%;差2例,占6.4%。结论同侧股骨干、胫骨多段骨折采用急诊手术固定,选择对骨折端扰乱较小的外固定架和加压钢板、带锁髓内钉固定治疗,是防止并发症,降低致残率,早期功能锻炼,恢复肢体功能的较好方法。

Objective To discuss the fixation methods to treat multi segmental fractures of ipsilateral femur and tibial shaft. Methods 32 patients with multi segmental fractures of ipsilateral femur and tibial shaft were treated with different methods of fixation, such as dynamic compression plate (DCP), locking intramedullary nails and unilateral external fixators. Results The follow ups of 6 months to 3 years showed that all the cases had been cured and the functions of all the limbs recovered. According to HSS grading system, the excellent rate was 80.6%(25 cases), the good rate was 12.9%(4 cases), and the poor rate was 6.4%(2 cases). Conclusion The multi segmental fractures of ipsilateral femur and tibial shaft should be treated by fixation in the emergency operation. It is advisable to adopt DCP, locking intramedullary nails and the external fixators with little disturbance to the fracture ends to prevent complications, decrease the disability rate and facilitate early functional rehabilitation of the limbs.