股骨单髁骨折微创外科术中应用单臂外固定架复位的效果观察.docVIP

股骨单髁骨折微创外科术中应用单臂外固定架复位的效果观察 作者：杨明川1，张殿英2，杨新民3，郝固磊1，张海鹏4 作者单位：(1.张家口市涿鹿中医院创伤骨科，河北 张家口 075600;2.北京大学人民医院创伤骨科，北京 100034;3.河北北方学院附属一院创伤骨科，河北 张家口 075600;4.张家口市涿鹿医院创伤外科，河北 张家口 075600) 　　【摘要】 目的 对股骨单髁骨折外科治疗的微创化进行观察探索。方法 68例股骨单髁闭合性骨折为微创组，采用小切口，钝性分离至膝关节囊，在C型臂X线透视下，将单臂外固定架的两固定针拧入断髁，之后把持架梁(臂)通过杠杆作用实现患髁复位，然后以加压松质骨螺钉内固定。复位前和固定后冲洗关节腔，术后不放引流管。疗效通过回顾性、非随机性对比进行评价。将微创组与77例膝关节切开复位内固定术患者组成的非微创组疗效进行对比分析。结果 据临床标准、X线标准评定，微创组优良率分别为100%和97.10%，非微创组优良率分别为67.53%和70.13%，差异均有显著意义(P0.05，P0.05)。结论 微创化的内固定方法对单髁新鲜骨折在保证良好复位的基础上，具有创伤小、显著减轻膝关节腔内外黏连因素、术后功能恢复快的特点，优于关节切开内固定术。 　　【关键词】 股骨骨折;微创外科;外固定 　　AFrame reduction for treatment of the femoral single condyle fractures 　　YANG Mingchuan,ZHANG Dianying,YANG Xinming,et al. 　　(Department of Traumatic Orthopedics，Zhuolu ChineseTraditionalMedical Hospital，Zhangjiakou 075600，China) 　　Abstract: Objective To evaluate the effect of a microinvasive surgery therapy(MST) for the femoral single condyle fracture(FSCF).Methods The microinvasive group consisted of 68 patients with the FSCF who received the MST from Feb.2001 to Jul.2007 in our hospital.The patients were operated with MST as follows: one little incision was made.Then the blunt dissociation from the incision to the joint capsule was performed.After the exposure of the joint capsule,2 fixation screw needles(FSN) of exfixation frame were fixed tightly into the broken condyle under the Xray television.Meanwhile the reposition of the broken condyle was conducted.Finally,the internal fixation was performed with compression screws.Joint cavity was lavaged both before reposition and after fixation without draining after surgery.The 67 cases of the microinvasive group had been followed up for 7 months to 3.5 years.And the effect of MST for the FSCF was analyzed compared with nonmicroinvasive group in which patients were treated with the anatomical reduction and intrafixation before 2001.Results In accordance with the clinical standard and Xray standard,the excellent rates of