双交锁髓内针内固定治疗“浮膝”骨折的临床应用_临床医学论文.docVIP

双交锁髓内针内固定治疗“浮膝”骨折的临床应用_临床医学论文 双交锁髓内针内固定治疗“浮膝”骨折的临床应用_临床医学论文 【关键词】 双交 摘 要：目的：探讨双交锁髓内针内固定治疗浮膝损伤的临床应用和意义。方法：对38例“浮膝”骨折病例均使用双交锁髓内针内固定治疗，根据不同骨折部位采用不同髓内针内固定，其中38例胫骨、15例股骨骨折切开复位，顺行髓内针内固定，13例股骨骨折骨采用逆行髓内针固定。结果：34例患者随访6个月至36个月，平均21个月，根据Karlstion和Oleruds功能评定标准：优16例，良18例，中3例。差1例。结论：交锁髓内针内固定治疗浮膝有利于减少术中软组织损伤，有防止骨折分离和旋转移位的作用，术后可早期活动，便于护理。骨折愈合快，减少患者住院和卧床时间；对稳定关节，减少感染，防止畸形愈合、不愈合等并发症有重要意义。 关键词: 膝损伤； 交锁髓内钉； 骨折固定术 Clinical Application of Double Locking Nail Fixation on Floating Knee Fracture Abstract：Objective：To investigate the clinical application and significance of double locking nail fixation on floating knee fracture . Method：All 38 cases of floating knee fracture were treated with locking nail fixation .Different parts of the fracture were treated with different locking nail internal fixation, 38 tibias, 15 femurs fractures were treated with open reduction and antergrade internal locking nail fixation. 15 femurs fractures were treated with retrograde locking nail internal fixation . Result：34 cases were followed up from 6 month to 36 month with an average of 21 month . According to Karlstion and Oleruds standard,16 cases were excellent, 18 cases were good, 3 cases were fair and 1 cases were poor. Conclusion：Locking nail internal fixation has advantage to the treatment of floating fracture and reduce soft tissue injury in operation , It is good to prevent fractureseparation and rotation displacement,early ambulant and easy to nursing care. Union of fracture is fast , reduce patient hospitalization and Lying in bed time ;it has important significance to stabilize joint, reduce infection, preventing malunion and disunion. Key words： Knee injuries; Locking nail； Fracture fixation 漂浮膝骨折是指同一肢体股骨干和胫骨干或干骺端骨折后，整段膝关节漂浮，造成双骨干不稳定骨折和处理困难的特殊损伤，不包括膝关节内（股骨髁和胫骨髁）骨折［1］。骨折由强大暴力引起，开放性骨折发生率高，常伴有全身多处复合伤，治疗较为困难。1996年至2001年我们使用双交锁髓内针内固定治疗浮膝骨折38例，取得满意疗效。 1 材料与方法 1.1 我院1996年至2001共收治38例漂浮膝骨折患者，男24例，女14例，年龄20～55岁。受伤原因：25例为交通事故伤，8例为高处坠落伤、重物砸伤和枪伤。25例闭合性损伤，13例开放性损伤，股骨和胫骨均为开放性损伤9例，伴有血管神经损伤12例，其它部位多发骨折5