单边外固定器治疗股骨髁上髁间复杂性骨折  

Treatment of Distal Femoral Fracture with Unilateral External Fixator

作　　者：王华东[1] 朱庆生[2] 侯树勋[1] 李文锋[1] 张伟佳[1] 

机构地区：[1]北京解放军304医院,北京100037 [2]第四军医大学西京医院骨科

出　　处：《实用骨科杂志》2005年第2期117-118,共2页Journal of Practical Orthopaedics

摘　　要：目的　探讨应用单边外固定器治疗股骨远端复杂骨折的适应证及治疗效果。方法　2 1例股骨髁上髁间粉碎性骨折患者,先采用膝前内侧切口,行股骨髁间骨折复位,解剖复位关节面,于股骨外髁部定位直视下用特制外固定螺纹针加压固定两髁部骨折。透视下闭合牵引复位髁上骨折,并撬拨整复游离骨折片,于骨折近端定位置入外固定针,安装紧固外固定器行骨折固定。结果　随访时间8～2 4个月,平均13.2个月,骨折在4～7个月内全部愈合,并去除外固定器。2例患者外固定针道感染,经去除固定针局部换药后愈合。根据Rasumssen评分(总分30分,膝关节活动功能0～6分)评价患者膝关节功能恢复情况,优良16例(76 .2 % ) ,一般4例(19% ) ,差1例(4.8% )。结论　单边骨外固定器治疗股骨髁上髁间复杂性骨折,具有创伤小,血运破坏少,骨折复位满意,可以早期功能练习等优点。尤其适用于应用内固定难以处理的长节段股骨髁上髁间粉碎性骨折,外固定器可多向、多部位调节,对骨折起到牵引、复位和固定的作用。Objective To study the indications and clinical effects of unilateral external fixator in the treatment of complicated distal femoral fracture. Methods 21 patients of complicated distal femoral fracture were treated with unilateral external fixator. All patients underwent an open reduction of the condyle with medial approach and close reduction of the super-condylar fracture with pin insertion and external fixation. Results The mean follow-up was 13.2 months(range 8 to 24 months).Union was achieved in all patients after 4 to 7 months with remove of the fixator.Two patients(10%) developed pin tract infection.According to Rasmussen Score excellent to good 16 cases(76.2%),fair 4 cases (19%),bad 1 case(4.8%).Conclusion External fixation is an alternative method in the treatment of complicated distal femoral fracture. External fixation can be performed with unstable fractures reduced to anatomical or nearly anatomical position by closed methods with offers significant advantages including higher tolerability, minimal surgical trauma, rapid weight bearing allowance, and achievement of union without seriously complicating events.

关 键 词：单边外固定器 复杂性骨折 股骨髁上 股骨远端复杂骨折 髁间粉碎性骨折 闭合牵引复位 关节活动功能 骨折复位 膝关节功能 骨外固定器 治疗效果 内侧切口 骨折患者 股骨髁间 解剖复位 髁部骨折 加压固定 髁上骨折 外固定针 

分 类 号：R683.42[医药卫生—骨科学] R816.98[医药卫生—外科学]