浮动膝损伤手术治疗探讨

目的：探讨浮动膝损伤的术式选择和疗效。方法：采用不同的手术方法治疗各类浮动膝损伤患者共48例。按张伯勋等分类方法分型。Ⅰ型12例。Ⅱ型20例,Ⅲ型16例。手术分别采用外固定架、钢板、交锁髓内钉固定。结果：全部病例均获得随访,随访时间11～32个月,平均19个月。膝关节功能采用Merchan标准评定,优31例,良13例,可3例,差1例。优良率91.7%。结论：对浮动膝损伤的患者要尽早手术治疗,根据不同类型和软组织条件选择手术方法,其中闭合复位交锁髓内钉内固定疗效最好。

EXPERIENCES OF THE SURGICAL TREATMENT OF FLOATING KNEE JOINT

Objective：To study the seletion of surgical methods and effectiv.eness of treatment of traumatic floating knee joint injury. Methods：Forty - eight cases with traumatic floating knee joint were classified into 3 types according to Zhang＇ s classification： 12 cases of Type Ⅰ ,20 cases of Type Ⅱ and 16 cases of TypeⅢ ,and underwent different surgical methods of external fixation apparatus,dynamic condylar plates and cross -lock intramedullary nail. Results ：All patients were followed up for 11 - 32 months（ average 19 months）. The outcome was evaluated with Merehan rating system,31 cases were graded as excellent, 13 cases as good,3 cases as fair, 1 cases as poor,knee joint function was excellent to good in 91.7%. Conclusion：Early operation will improve the effetiveness of treatment of traumatic floating knee joint injury. To select surgical methods according to .types of fractures and soft tissues iniured,the excellent effect is cross - lock intramedullary nail for fixation with close reduction.