骨科知识介绍-(45).docVIP

逆行交锁髓内钉结合松质骨螺钉治疗股骨髁间粉碎性骨折 作者：潘奇，程银树，时强，张立人 作者单位：（宿州市立医院骨科，安徽 宿州 234000） 【摘要】 目的 总结逆行交锁髓内钉结合松质骨螺钉治疗股骨髁间粉碎性骨折的经验和疗效。方法 对应用逆行交锁髓内钉结合松质骨螺钉治疗股骨髁间粉碎性骨折62例的临床资料进行回顾性分析。结果 随访6～12个月，平均9个月。62例全部骨性愈合，骨折平均愈合时间4个月。根据Hohl膝关节功能评定标准评定：优52例，良8例；优良率96.8%。2例出现浅表感染，1例术后出现脂肪栓塞。结论 股骨逆行交锁髓内钉结合松质骨螺钉能够提供坚强内固定，治疗股骨髁间粉碎性骨折有较高的临床应用价值。 【关键词】 股骨髁间骨折；内固定；交锁髓内钉；螺钉 　　Treatment of comminuted femoral intercondylar fracture with retrograde interlocking intramedullary nail and cancellous screw 　　PAN Qi,CHENG Yinshu,SHI Qiang，et al. 　　（Department of Orthopaedics,Municipal Hospital,Suzhou 234000，China） 　　Abstract： Objective To summarize the effect of using retrograde interlocking intramedullary nail and cancellous screw in the treatment of comminuted femoral intercondylar fracture.Methods From May 2001 to August 2006,62 cases of the fresh comminuted femoral intercondylar fractures were treated with retrograde interlocking intramedullary nail and cancellous screw.Results Sixtytwo cases were followedup for 612 months(mean 9 months).The bone healing was achieved in all patients.The average time of bone healing was 4 months.The functional scores on Hohl: 52 were excellent and 8 good，with an excellent and good rate of 96.8%.There were 2 cases of superficial infection and 1 case of fat embolism syndrome.Conclusion It is a good methed to use retrograde interlocking intramedullary nail and cancellous screw to treat the comminuted femoral intercondylar fracture.It can provide a stable and reliable fixation.It facilitates the fracture healing and functional recovery of the knee joint.The effect is excellent. 　　Key words：femoral intercondylar fracture;internal fixation;interlocking intramedullary nail;screw 　　股骨髁间粉碎性骨折临床上多见，目前以手术内固定治疗为主［1］。自2001年5月～2007年4月，我科对此种类型的骨折采取逆行交锁髓内钉加松质骨螺钉固定治疗，取得了较好的效果。 　　临床资料 　　1 一般资料 　　资料完整且获得随访的病人共62例，男性37例，女性25例；年龄在20～76岁，平均37岁。致伤原因：道路交通伤52例，坠落伤7例，压砸伤3例。全部病人均为新鲜骨折，其中开放性骨折28例，合并其他器官损伤有15例。骨折均按AO分型［2］：C1型20例，C2型38例，C3型4例。术前常规应用抗生素及胫骨结节骨牵引1～7天。主要合并伤为眶底骨折并视神经损伤、蛛网膜下腔出血