股骨下端骨折的逆行交锁髓内钉治疗

目的 报告应用逆行交锁髓内钉治疗股骨下端骨折（包括髁间、髁上、股骨下段）的方法及效果。方法 通过经膝正中切口髌旁内侧入路，应用逆行交锁髓内钉内固定股骨下端骨折46例，其中髁间骨折8例，髁上骨折22例，涉及股骨下段骨折16例，获得远期随访43例，进行评定效果。结果 早期有计划步骤地进行膝关节康复训练，临床随访8－20个月，骨愈合良好，平均骨愈合时间4．5个月，膝关节功能恢复好，无膝内外翻畸形及骨性关节炎出现，优良率为91．3％；术后2例髌前皮肤部分坏死，1例近端1枚锁钉松动退出，近端锁钉断裂1例。结论 本法具有复位可靠，固定牢固，适应早期关节康复练习，并发症少，有良好的临床实用价值。

Retrograde locked intramedullary pin for distal end of the femur fracture

Objective To report the therapeutical methods and effect of supracondylar and intercondylar fracture of the distal end of the femur using the retrograde locked intramedullary pin.Methods Fourty-six patients with distal end of the femur fracture including,8 cases of intercondylar fracture,22 cases of supracondylar fracture and 16 cases of distal femur fracture were treated with retrograde locked intramedullary pin by knee centric notch inside knee cap.Fourty-three patients were followed-up and the effect was evaluated.Results The follow-up period was 8 to 20 months.Fracture union was well and the mean time of fracture union was 4.5 months.The function of knee joint recovered well without inversion eversion and bony arthritis.The excellent rehabilitation rate was 91.3%.After operation,prepatellar skin necrosis was found in 2 patients,proximal locking screw slack or broken was found in 1 patient respectively.Conclusion Retrograde locked intramedullary pin for distal end of the femur fracture was a good method that has practical value clinically,and it can stable femoral shaft to adapt early rehabilitation exercise with few complications.