股骨髁上闭合性骨折合并坐骨神经损伤的治疗  

Treatment of closed supracondylar femoral fracture complicated with sciatic nerve injury

作　　者：王文[1] 李秉胜[1] 刘立峰[1] 张永先[1] 王平山[1] 曹学成[1] 

机构地区：[1]济南军区总医院骨创伤科,济南250013

出　　处：《中华神经创伤外科电子杂志》2015年第2期24-26,共3页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的：探讨股骨髁上闭合性骨折合并坐骨神经损伤的创伤机制及治疗。方法选择自济南军区总医院骨创伤科2000年1月至2014年6月收治的股骨髁上骨折患者316例，分析本组共15例股骨髁上闭合性骨折合并坐骨神经损伤患者病情，并行手术治疗，采用复位固定术，坐骨神经探查，神经松解减压或束膜吻合，临床随访采用神经功能愈合标准（MCRR）进行恢复情况评估。结果本组15例患者术前肌电图检查结果表现为：9例患者神经传导速度轻度减慢、电位波幅轻度降低、潜伏期轻度延长者；其中8例患者术后随访神经恢复优4例，良3例，可1例。6例患者术前肌电图提示神经传导速度明显减慢、电位波幅明显降低、潜伏期明显延长。临床随访6个月~3年，按肌电图检查结果分组进行MCRR标准评分的结果，坐骨神经恢复情况：优6例，良4例，可3例，差2例。结论肌电图检查结合术中肉眼观察坐骨神经损伤程度对指导手术和判断预后有一定意义。Objective To investigate the mechanism and treatment of supracondylar femoral closed fracture associated with sciatic nerve injury. Methods 15 cases of supracondylar femoral closed fracture associated with sciatic nerve injury patients underwent surgical treatment. The fracture was taken reposition and fixation, sciatic nerve exploration, nerve decompression or fascicular suture. Results The occurrence of excellent nerve recovery was 6 cases, fair recovery was 4 cases, poor recovery was 3 cases, bad recovery was 2 cases. Conclusions Patients with supracondylar femoral closed fracture associated with sciatic nerve injury should underwent the surgery as soon as possible, with the operation of fracture reposition and fixation, sciatic nerve exploration, nerve decompression or fascicular suture, in order to obtain a better outcome. It has a positive effect in operation and prognosis on the electromyography with intraoperative visual observation of the extent of sciatic nerve injury.

关 键 词：股骨骨折 闭合性骨折 坐骨神经 损伤 

分 类 号：R687.3[医药卫生—骨科学]