膝关节周围骨折合并血管神经损伤60例临床分析

目的探讨膝关节周围骨折合并血管神经损伤的临床治疗效果。方法我院2007年2月～2011年2月共收治膝关节周围骨折合并血管神经损伤患者60例,视患者受伤的具体情况为其进行骨折复位及血管、神经修复治疗,并观察记录其临床疗效。结果 8例患者截肢,52例患者的患肢完全成活,且无严重的肢体缺血及术后并发症,治愈率为86.67%。挫伤27根神经,22例完全恢复,5例部分恢复;断裂9根神经,7例感觉运动恢复良好,2例较差;治愈率为80.56%。结论对膝关节周围骨折合并血管神经损伤患者采取恰当的处理与及时的治疗手段,可有效提高患肢的治愈率,血管及神经的恢复情况也较好,且对改善骨折预后有着重要的作用,尤其是术中所需骨折固定物的挑选、修复顺序、血管吻合情况都是影响手术成功的关键因素

Clinical analysis of 60 cases of fractures around the knee with concurrent vascular and nerve injury

Objective To investigate therapeutic efficacy for fractures around the knee with concurrent vascular and nerve injury.Methods 60 cases of patients who had fractures around the knee with concurrent vascular and nerve injury were admitted to our hospital from February 2007 to February 2011.Patients were given fracture reduction,vascular repair or nerve repair depending on degree of injure.Therapeutic efficacy of the treatments was recorded.Results 8 patients underwent amputation and injured limbs of 52 patients survived without severe limb ischemia or postoperative complications.The cure rate was 86.67%.22 out of the 27 cases of nerve contusion fully recovered and the other 5 cases recovered partially;7 out of 9 patients with breaking nerves regained good sensorimotor function,and the other two patients regained only poor sensorimotor function;the cure rate was 80.56%.Conclusion Appropriate and timely treatment of fractures around the knee with concurrent vascular and nerve injury can effectively improve the cure rate of injured limb,improve the recovery of blood vessels and nerves and to improve the prognosis which plays an important role in fracture,especially in fracture fixation surgery required the selection of repair order,vascular anastomosis are the key factors affecting the success of surgery.