股骨髁上严重粉碎骨折后手术重建  

Reconstruction and Fixation Exclusion and Internal Fixations for Complex Supracondylar Femoral Fractures

作　　者：何明 陈秉虎 黎彦龙 王天学 康学文[2] 宋敏[3] 陈秉雄 

机构地区：[1]临洮县人民医院,甘肃定西730500 [2]兰州大学第二医院,甘肃兰州730000 [3]甘肃中医学院,甘肃兰州730000

出　　处：《中国医药指南》2015年第24期1-2,共2页Guide of China Medicine

基　　金：国家自然基金(No:81360554);吴阶平医学基金会临床科研专项资助基金(No.320.6750.11061);甘肃省省青年科技基金计划(No.1208RJYA066);甘肃省自然科学基金项目(No.1010RJZA160)

摘　　要：目的 探讨骨折区旷置内固定治疗股骨髁上严重粉碎骨折的有效性。方法 总结分析自2005年1月至2008年12月间我科收治且经骨折区旷置手术治疗的股骨髁上严重粉碎骨折19例。其中AO分型中A3型11例,C2型8例;新鲜骨折15例,陈旧性骨折2例,骨折不愈合2例。开放性骨折3例,闭合性骨折16例。术中骨折区复位后,应用股骨髁支持钢板内固定,取自体髂骨或髂骨结合腓骨植入填充骨缺损区,对骨折区旷置不做内固定,于骨折区两侧以钉板内固定。结果 19例患者手术经过顺利,术中出血260~800 m L,伤口浅部感染延迟愈合1例,无其他并发症出现。随访19∽50个月,复查X线片全部达到骨性愈合,愈合时间15~42周。HSS膝关节临床功能评分：优8例,良8例,可3例,差0例。结论 骨折区旷置、植骨重建、钉板内固定是治疗股骨髁上严重粉碎骨折和防止并发症的有效方法。Objective To discuss the efficacy of recons~＇uction and fixation exclusion and internal fixations for complex supracondylar femoral fractures. Methods A retrospectively studies were performed on 19 cases of complex supracondylar femoral fractures who had＇received operative treatment in our department from January 2005 to Dec 2008, their ages were from 26 to 59 years. There were 11 fractures of type A3 and 8 fractures of type C2 according to AO classifications. All patients obtained operation of reconstruction and fixation exclusion and internal fixations. Results All operations were completed successfully. 19 cases were followed up from 19 to 50 months postoperatively to observe clinical efficacy. 1 case was wound indolence because of infection and healed there weeks later. X-ray photos showed that all cases obtained fractures union at 15 to 42 weeks after operation. According to HSS score： 8 cases were excellent, 8 good, 3 fair. Conclusion The treatment of reconstruction and fixation exclusion and internal fixations were available in complex

关 键 词：股骨髁上粉碎骨折 重建 内固定 

分 类 号：R683.42[医药卫生—骨科学]