创伤性"浮膝"骨折37例诊治体会

目的　总结本院 1990～ 1997年收治的 37例、39个“浮膝”骨折损伤的治疗及愈合情况 ,探讨适用受伤初期全身情况和膝关节功能恢复的最佳治疗方法。方法　对病人伤时全身情况、不同治疗方法、合并症、骨折愈合及下肢功能恢复进行统计分析和评定。追踪时间 2～ 10年 ,平均 4 .8年。结果　 2 2个股骨和15个胫骨骨折采用带锁髓内针内固定 ,6个股骨和 5个胫骨骨折用钢板内固定 ,5个股骨和 7个胫骨骨折行单臂支架外固定 ,其它用石膏或牵引外固定治疗。优良率 78.38%。结论　“浮膝”骨折是一种重度不稳定损伤 ,应给予一处骨折内固定或支架外固定 ,使其成为单一骨折。现代带锁髓内针对骨折坚强内固定疗效明显优于其它治疗方法

Floating knee: experiences of diagnosis and treatment of 37 cases

Objective To sum up the experiences of the floating knee in 37 cases and to evaluate method of treatment.?Methods With the retrospective investigation of the floating knee treated in First Affiliated Hospital,Zhongshan University from 1990 to 1997,the condition of whole body,different measures of treatment, complication, concrescence of fracture and function of the knee were analyzed.?Results There were 39 cases of floating knee in 37 patients;the follow up time is from two to ten years,average for 4.8 years. Twenty two cases of femur fracture and 15cases of tibia fracture were fixed with the intramedullary nail with lock,six cases of femur fracture and three cases of tibia were fixed with the plate,six cases of femur fracture and seven cases of tibia were fixed with the bracket,other cases were fixed with the plaster or traction. The percentage of good outcome is 78.38%.?Conclusion The fracture of floating knee is a kind of severe unstable wound;?severe case should be fixed internally to change to the case into a single fracture. The outcome of the intramedullary nail with lock with steady fixation is better than others.