同侧股骨和胫骨骨折73例分析  

An analysis of 73 cases of ipsilateral femoral and tibial fractures

作　　者：符气祯[1] 李佛保[1] 黄钢[1] 廖威明[1] 

机构地区：[1]中山大学第一附属医院骨科,广东广州510080

出　　处：《临床骨科杂志》2004年第1期45-48,共4页Journal of Clinical Orthopaedics

摘　　要：目的　探讨同侧股骨和胫骨骨折患者最佳治疗方法。方法　对 73例患者 (77侧 )伤时全身情况、不同治疗方法、合并症、骨折愈合及下肢功能恢复进行分析和评定。 2 4侧股骨和 2 1侧胫骨骨折采用带锁髓内钉固定 ,13侧股骨应用“V”型钉或梅花针固定 ,17侧股骨和 2 1侧胫骨应用钢板内固定 ,4侧股骨和 6侧胫骨行单臂支架外固定 ,其他石膏或牵引治疗。结果　总优良率 6 4 71%。股骨和胫骨均坚强内固定 (Ⅰ组 )优良率 72 4 0 % ;一处骨折坚强内固定 ,另一处非手术治疗 (Ⅱ组 )优良率 6 3 33% ;股骨和胫骨均非手术治疗 (Ⅲ组 )优良率 4 4 4 4 %。结论　同侧股骨和胫骨骨折是一种重度不稳定损伤 ,二处骨折均坚强内固定为理想治疗方法 ;危重患者应给予一处骨折内固定或支架外固定 ,使其成为单一骨折 ;Objective To investigate the optimal treatment of ipsilateral femoral and tibial fractures. Methods 73 cases (77 limbs) of ipsilateral femoral and tibial fractures were reviewed. The systemic situations, varied treatments, complications, fracture healing and the limb functions were compared. 24 cases of femoral fracture and 21 cases of tibial fracture were treated with interlocking intromedullry nailing,13 femoral fracture with 'V' or cloverleaf nailing,17 femoral fracture and 21 tibial fracture with plating and 4 cases of femoral fracture and 6 cases of tibial fracture with unilateral external fixation. The rest were treated with plaster or traction immobilization. Results The total excellent and good rate was 64.71%. The rate was 72.40% in those both femur and tibia were treated with rigid fixation (Group Ⅰ),63.33% in those one with rigid fixation and the other with nonsurgical treatment (Group Ⅱ),and 44.44% in those both with nonsurgical treatment (Group Ⅲ). Conclusion Ipsilateral femoral and tibial fractures are kinds of severe unstable fracture, and the optimal treatment is that both the femur and tibia are treated with rigid fixation. For the life-threatening cases, at least one fracture should be stabilized with close or open method to make the two fractures into one. The modern intramedully nail is much more effective than the others in rigid fixation of fracture.

关 键 词：股骨骨折 胫骨骨折 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]