股骨远端逆行交锁钉加骨栓治疗股骨髁粉碎性骨折

目的 评价股骨髁上交锁髓内钉加骨栓治疗股骨远端粉碎骨折的效果。方法 应用股骨髁上交锁髓内钉加骨栓治疗股骨髁上髁间粉碎性骨折42例,AO分型均为C1-2型。术中先将髁间骨块复位拉力钉固定,再将髁上复位逆行穿入髁上交锁髓内钉,髓内钉远端的一枚锁钉用骨栓取代,如数穿入其他锁钉。结果 42例患者均得到随访,骨折愈合时间3.5~7.0个月,平均4.6月。膝关节活动范围平均3°~115°。根据Neer膝关节功能评分标准,优≥86分,良≥72分,可≥56分,差<56分。优31例,良10例,优良率91.67%;接受1例(8.3%),差0例。结论 采用股骨远端逆行交锁髓内钉加骨栓是治疗股骨髁上及髁间骨折的理想方法。骨栓可有效控制股骨髁间分离,多数患者可通过早期膝关节功能训练达到理想的功能效果。

Retrograde intramedullary locked nail and bolt for comminuted fracture in the femur condyles

Objective To evaluate the therapeutic effects of locked supracondylar intramedullary nail and bolt for treating comminuted fracture in the distal end of the femur. Methods Forty-two patients (including 31 male and 11 female patients) with supracondylar and intercondylar fractures, classified into type C1 in 20 cases and type C2 in 22 cases according to AO classification, were treated with retrograde intramedullary nail and bolt. Results The follow-up period ranged from 3 to 18 months and the average time of bone healing was 4.6 months. Assessed by functional scoring, the results were excellent in 31 patients, good in 10, and acceptable in 1, with the rate of excellent result as high as 97.6%. Conclusions Retrograde intramedullary nail and bolt can be ideal for treating supracondylar and intercondylar fractures. The bolt can effectively control the dissociation of the intercondylar fractures and good functional recovery of the knee joint can be achieved through early functional training.