关节镜辅助下逆行髓内钉治疗股骨远端骨折的疗效观察  

Treatment of Distal Femoral Fractures with Retrograde Interlocking Intramedullary Nails under Arthroscopy

作　　者：黄长明[1,2] 傅仰攀[1,2] 范华强[1,2] 王建雄[1,2] 张少战[1,2] 陈灿辉[1,2] 唐聪[1,2] 卢海燕[1,2] 甘志勇[1,2] 董辉详[1,2] 

机构地区：[1]厦门大学附属成功医院骨科 [2]解放军第174医院骨科,福建厦门361003

出　　处：《实用骨科杂志》2014年第6期555-557,共3页Journal of Practical Orthopaedics

摘　　要：目的：总结采用关节镜辅助下逆行髓内钉系统治疗股骨远端骨折的临床疗效。方法自2008年2月至2012年8月，用关节镜辅助下逆行髓内钉系统治疗股骨远端骨折13例，左侧6例，右侧7例。其中男8例，女5例；年龄20～72岁，平均49.3岁。按AO分型，A1型9例，A2型4例。采用Merchant评分评价术后膝关节功能。结果13例患者均获得随访，随访时间为10～34个月，平均18.7个月。术后X线片显示股骨骨折均愈合，无血管神经损伤、感染，膝关节内外翻、内固定松动断裂等发生。按Merchant评分评定，优10例，良2例，可1例，优良率92.3％。结论关节镜辅助下逆行髓内钉治疗股骨远端骨折具有创伤小、操作简单、定位准确、固定牢靠、能及时发现并处理膝关节内病变等优点。Objective To summarize the clinical results of distal femoral fractures with retrograde interlocking intramedullary nails under arthroscopy. Methods Between February 2008 and August 2012,13 cases of closed distal femoral fractures were treated by operation. There were 8 males and 5 females with an average age of 49. 3 years（range,20 ～72 years）. According to AO classification for fractures,there were 9 cases of type A1,4 cases of type A2. The knee joint function after surgery were evaluated by Merchant performance score. Results Thirteen cases were followed up for 10 ～34 months（18. 7 months on average）. At the time of the last follow-up,All the patients obtained satisfactory results after operation without joint infection. Postoperative X-ray showed femoral fracture callus healing,no blood vessels,nerve injury,infection,Knee valgus,and loosening internal fixation occurred. According to Merchant performance score,the results were excellent in 10 cases,in 2 cases,and fair in 1 case with an excellent and good rate of 92. 3%. Conclusion The use of arthroscopic retrograde intramedullary interlocking nails not only help fixation,but also benefit diagnosis and treatment of the complications of knee in time.

关 键 词：关节镜辅助 逆行髓内钉 股骨远端骨折 

分 类 号：R683.42[医药卫生—骨科学]