经胫骨结节截骨入路治疗股骨髁间复杂骨折

发布时间：2018-03-27 19:00

本文选题：胫骨结节截骨　切入点：股骨髁间复杂骨折　出处：《中国矫形外科杂志》2017年20期

【摘要】：[目的]探讨胫骨结节截骨在显露困难的股骨髁间复杂骨折中应用的可行性及效果。[方法]2008年7月~2015年10月,采用胫骨结节截骨、股骨远端外侧解剖锁定钢板内固定的方法治疗股骨髁间复杂骨折(AO分型:C3.3型)12例,其中男10例,女2例,年龄25~49岁,平均33岁。观察手术时间、术中出血量、术后伤口愈合情况、末次随访时膝关节功能恢复、骨折愈合及有无钢板断裂等。[结果]手术时间125~155 min,平均132 min;术中出血量250~450 ml,平均320 ml。11例获得随访,随访时间10~28个月,平均21个月。术后6个月复查X线片示所有胫骨结节截骨块均完全愈合,无伤口感染、骨折不愈合及延迟愈合现象,随访期间未发现股骨远端骨折内固定松动及断裂。末次随访时根据Merchan[1]等的临床评分标准:优4例,良6例,差1例,失访1例,优良率90.9%。[结论]胫骨结节截骨能充分显露股骨远端,利于关节面的解剖复位和可靠固定。
[Abstract]:[objective] to investigate the feasibility and effect of tibial nodule osteotomy in complex femoral intercondylar fractures with difficult exposure. [methods] from July 2008 to October 2015, tibial nodule osteotomy was used. 12 cases of complex femoral intercondylar fractures were treated by internal fixation with anatomic locking plate for distal femur, including 10 males and 2 females, aged 2549 years (mean 33 years). The operative time and blood loss during operation were observed. Postoperative wound healing, recovery of knee joint function at the last follow-up, fracture healing and plate breakage, etc. [results] the operative time was 125 ~ 155 min (mean 132 mins), the blood loss during operation was 250 ~ 450 ml (mean 320 ml.11), the follow-up time was 10 ~ 28 months. The average was 21 months. 6 months after operation, X-ray examination showed that all the osteotomies of the tibial nodule were completely healed, no wound infection, nonunion of fracture and delayed healing. There was no loosening and fracture of internal fixation in distal femur fracture during follow-up. According to the clinical scoring criteria of Merchan et al: excellent 4 cases, good 6 cases, poor 1 case, lost visit 1 case. [conclusion] Osteotomy of tibial nodule can fully expose distal femur, which is beneficial to anatomical reduction and reliable fixation of articular surface.
【作者单位】：广州中医药大学;东莞市常平医院;
【分类号】：R687.3

【相似文献】