股骨干骨折合并股骨髁冠状面骨折的治疗

目的探讨股骨干骨折合并股骨髁冠状面骨折的诊断和治疗。方法回顾性分析自2005年1月至2007年12月，笔者所在医院骨科收治的股骨干骨折合并股骨髁冠状面骨折5例，均为内髁，所有病例均系车祸受伤。股骨干骨折切开复位钢板内固定，股骨髁冠状面骨折采用切开复位松质骨拉力螺钉内固定，其中1例股骨干骨折术后X线复查才发现股骨髁冠状面骨折，行再次手术。结果术后伤口均一期愈合，x线片显示骨折解剖复位，5例病例均获得了6—12个月随访，骨折愈合时间为10-14周，根据膝关节功能评估标准：优3例，良2例。结论股骨干骨折合并股骨髁冠状面骨折系高能量损伤，主要累及内髁，此种合并伤少见，易漏诊，需常规显示股骨髁侧位像。手术治疗后膝关节功能近期效果良好。

The treatment to femoral shaft fracture combined with coronal fracture of femoral condyle

Objective To evaluate the diagnosis and treatment to femoral shaft fracture combined with coronal fracture of femoral condyle. Methods From January 2005 to December 2007, 5 patients with femoral shaft fracture combined with coronal fracture of femoral condyle in our hospital were included, all the coronal plane fracture of the femoral condyle were situated inside. All the 5 cases were injured in motorbike traffic accident. The femoral fracture were reduced under direct vision and fixed with sheet steel, and the coronal fracture of the femoral condyle were reduced under direct vision and fixed with cancellous lag screw, of which 1 patient was founded coronal fracture of the femora! condyle in the x - ray inspection at the last day after the femoral fracture operation. Results The incisions were all healed by first intention. The x - ray films showed that the fractures were anatomic reduction. The healing time was 10 weeks to 14 weeks, and all patients were followed up for 6 months to 12 months. According to knee joint functional assessment system, 3 cases were excellent and good, 2 cases fine, none poor. Conclusion In the femoral shaft fracture combined with coronal fracture of femoral condyle, the fracture frequently occurs inside. This type of fracture is rare and easy missing, and femoral condyle x - ray film should be taken in femoral fracture case.