股骨远端骨折术后伸直性膝关节僵硬的治疗及影响因素分析  

Analysis of outcome and affecting factors in treatment of extension contracture of knee after surgical operation for distal femoral fractures

作　　者：黄淑明[1] 兰树华[1] 郑荣宗[1] 吕国强[1] 吴泉州[1] 应锦河[1] 

机构地区：[1]浙江省丽水市中心医院骨科,323000

出　　处：《中国骨与关节损伤杂志》2013年第7期644-646,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨股骨远端骨折术后伸直性膝关节僵硬的手术疗效，并分析其影响因素。方法对自2006年5月～2011年12月采用关节镜联合小切口粘连松解术治疗的17例股骨远端骨折术后伸直性膝关节僵硬进行回顾性研究，采用Judet疗效评定标准评价膝关节功能，并对股骨远端骨折术后发生膝关节僵硬的诸多因素及影响粘连松解术后疗效的相关因素进行分析。结果本组获随访6～73个月，平均31个月。末次随访时膝关节功能根据Judet疗效评定标准：优9例，良7例。可1例。术中及末次随访时膝关节活动度与术前膝关节活动度比较明显改善（P〈0．05），粘连松解术的疗效与术前膝关节的活动度、松解术的手术时期、术中松解程度有关。结论应用关节镜联合小切口粘连松解术，辅以早期功能锻炼是治疗股骨远端骨折术后伸直性膝关节僵硬较有效的方法，其手术创伤小、术后功能康复良好、并发症少。Objective To analyze the affecting factors and clinical results of treatment of extension eontraeture of the knee after surgical operation for distal femoral fractures. Methods A retrospective survey was analyzed from May 2006 to December 2011. A total of 17 patients with extension contraeture of the knee after surgical operation for distal femoral fractures were treated surgically by less invasive procedure and arthroscope techniques. The function of the knee was evaluated with the Judet criteria.Various factors probably resulted to extension eontraeture of the knee after surgical operation for distal femoral fractures were analyzed, and vanous factors probably correlated with adhesion lysis ettleaey were also analyzed. Results All patients were followed up for 6 to 73 months, with an average of 31 months. The knee joint function was assessed according to the Judet criteria, 9 eases achieved exeeflent resuhs,7 good,1 fair at final follow up. The range of motion of the knee during operation and at the last time of follow-up was better than that before operation （P 〈0.05）. The definitive flexion gain after knee adhesion release operation were correlated with preoperative flexion range of the knee, preoperative interval of adhesion lysis, and with degree of lysis. Conclusion It is a minimal trauma,and promising procedure with satisfactory results to treat the stiff knee with arthroseopieal and less invasive adhesion lysis surgery, assisted by early and effective functional exercise. It can not only noticeably reduce the complication but also improve the functional rehabilitation.

关 键 词：股骨骨折 膝关节僵硬 松解术 关节镜 小切口 

分 类 号：R683.42[医药卫生—骨科学]