开放性股骨髁上骨折28例手术治疗临床分析  

Retrospective analysis of 28 patients with open femoral supracondylar fractures treated by surgical treatment

作　　者：何吉亮[1] 郝振海[1] 周东生[1] 许世宏[1] 马玉鹏[1] 

机构地区：[1]山东大学附属省立医院创伤骨科,山东省济南市250021

出　　处：《中国骨与关节损伤杂志》2013年第8期713-715,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的回顾性分析开放性股骨髁上骨折治疗的临床资料，评价其治疗效果。方法对28例开放性股骨髁上骨折术中彻底清创，Anderson—GustiloI型骨折采用内固定治疗；Anderson—GustiloⅡ、IIA型骨折视软组织情况，采用内固定或外固定架固定；Anderson—GustiloIIB、C型骨折均采用外固定架固定治疗。一期或延迟封闭创面。结果28例获6．24个月（平均12．7个月）随访。3例发生浅表感染，无骨髓炎发生，2例因骨折不愈合再次行手术治疗，3例发生创伤性膝关节炎。末次随访时膝关节Merchant评分：优10例，良14例，可3例，差1例，优良率85．7％。结论开放性股骨髁上骨折损伤重、处理难度大，选择合适的固定方式、正确处理骨折及软组织损伤、减少感染等并发症的发生是治疗的关键。Objective To investigate the clinical results of treatment of open femoral supracondylar fractures. Methods Twenty eight cases of open femoral supracondylar fractures were treated. Internal fixation was used in type Anderson-Gustilo I, external fixator in type Anderson-Gustilo HI B,C, treatment of type Anderson-Gustilo II and III A depending on soft tissue trauma. Skin grafts or skin flaps were used to repair soft tissue defects. Results All of 28 cases were followed up for 6-24 months （average 12.7 months）. Three cases had superficial infection. Two eases failed to obtain union and had to receive another operation.Three cases had traumatic arthritis. At the last follow-up, according to Merchant scoring, the results were excellent in 10 cases, good in 14 cases, fair in 3 cases, poor in 1 ease,and an excellent and good rate was s5.7%. Conclusion The key to treat open femoral supracondylar fractures lies in the way of fixing fracture, treatment of soft tissues, reducing infection complication and early practice.

关 键 词：股骨髁上骨折 开放性骨折 内固定 外固定架 

分 类 号：R687.3[医药卫生—骨科学]