微创双交锁髓内钉固定治疗Fraser I型浮膝损伤  

Treatment of Fraser type I floating knee injuries with double intramedullary nail under minimally invasive surgery

作　　者：郭志民[1] 王瑛 林秋燕[1] 林斌[1] 

机构地区：[1]厦门大学附属东南医院,解放军第一七五医院全军创伤骨科中心,漳州363000 [2]总参卫星导航定位中心门诊部

出　　处：《中华创伤杂志》2011年第11期986-989,共4页Chinese Journal of Trauma

基　　金：南京军区医药卫生科研基金资助项目（07M066）

摘　　要：目的探讨微创双交锁髓内钉固定治疗浮膝损伤的作用。方法2006年7月-2010年7月采用支架、牵开复位器等微创方法辅助胫骨交锁钉和股骨逆行交锁钉治疗FraserI型浮膝损伤患者23例，术后行下肢连被动运动（CPM）功能锻炼。结果手术时间70～160min，平均95min；术中出血量100～600ml，平均260ml。23例患者术后获得随访7～35个月，平均11个月。根据Kadstrom和Olerud功能评定标准进行疗效评定：优17例，良4例，中2例，优良率为91％。结论应用便携式下肢手术支架、AO牵开复位器及带手柄的Schanz钉辅助骨折复位等方法，使采用双交锁钉内固定治疗FraserI型浮膝损伤的操作更加微创、快捷。Objective To discuss role of double intramedullary nail in the treatment of floating knee injuries under minimally invasive surgery. Methods From July 2006 to July 2010 , 23 patients with floating knee injuries （Fraser type I ） were fixed with tibial intramedullary nail and femoral retro- grade intramedullary nail assisted by minimally invasive method such as portable bracket, AO large distractor and Schanz screw. The postoperative continuous passive motion （ CPM ） was performed for functional exercises of the knee. Results The operation lasted for average 95 minutes （range, 70-160 minutes） , with average blood loss of 260 ml （range, 100-600 ml）. All patients were followed up for average 11 months （range, 7-35 months）. According to assessment systems of Karlstrom and Olerud, the clinical results were excellent in 17 patients, good in 4 and fair in 2, with excellence rate of 91%. Conclusions Combined with the methods of portable bracket of lower limb, AO large distractor and Schanz screw, the intramedullary nail is much convenient and minimally invasive for the floating knee injuries.

关 键 词：膝关节 骨折固定术 髓内 浮膝损伤 

分 类 号：R687.3[医药卫生—骨科学]