髁上交锁髓内钉加稳定螺母治疗股骨髁间粉碎骨折

目的 探讨股骨髁上交锁髓内钉加稳定螺母治疗股骨髁间粉碎骨折的优势。方法 本组18例股骨髁间粉碎骨折的病例，按AO分类，C1型2例，C2型10例，C3型6例，均采用股骨髁上交锁髓内钉加稳定螺母进行治疗。结果 随访6～29个月，18例骨折全部愈合，平均愈合时间3．5个月，按Noyes的评分标准评定膝关节功能，优6例，良10例，可2例，优良率达88．89％。结论 股骨髁上交锁髓内钉加稳定螺母是目前治疗股骨髁间粉碎骨折的有效选择之一，但术中应注意解剖复位，牢固固定、钉长合适及术后早期功能锻炼等以避免膝内外翻畸形、下肢短缩旋转畸形、膝关节僵硬、骨性关节炎、撞击综合征及骨不连或骨延迟愈合的发生。

Treatment of femoral intercondylar comminuted fracture with retrograde intramedullary supracondylar nail and stable screw nut

Objective To investigate the advantages of the treatment of femoral intercondylar comminuted fracture with retrograde intramedullary supracondylar nail and stable screw nut. Methods 18 cases of the fresh femoral intercondylar comminuted fracture were treated with retrograde intramedullary supracondylar nail and stable screw nut. According to AO classification system, there were 2 cases of type C1, 10 cases of type C2, and 6 cases of type C3. Results All the 18 cases were followed up for 6 to 29 months. All the fractures healed and the mean fracture union time was 3.5 months. According to Noyes knee score code, 6 were rated as excellent, 10 good, 2 fair, and 0 poor. The excellent and good rate was 88.89%. Conclusions The treatment of femoral intercondylar comminuted fracture with retrograde intramedullary supracondylar nail and stable screw nut is one of the effective methods. But enough care should be paid to the anatomic reduction, rigid fixation, appropriate length of the nail and early functional exercises so as to prevent the inversion and eversion deformation of the knee, shortness and rotation deformation of the leg, knee ankylosis, osteoarthritis, struck syndrome, nonunion and delayed union.