髌骨骨折合并同侧股骨外髁骨折临床分析

目的:探讨髌骨骨折合并同侧股骨外髁骨折的临床特点及治疗方法。方法:2000年1月—2008年4月共收治14例髌骨骨折合并同侧股骨外髁骨折患者,且均行手术治疗。髌骨骨折应用张力带钢丝固定、钢丝环扎固定、髌骨下极切除、髌韧带重建,股骨外髁骨折采用松质骨螺丝钉固定或克氏针固定。结果:12例患者得到随访,随访时间平均为13个月。膝关节功能按Merchan评定标准,优7例,良3例,中1例,差1例,优良率为83.3%。结论:髌骨骨折合并同侧股骨外髁骨折,基层医院漏诊率较高,术前应认真阅读X片,对可疑者可作膝关节CT等以便明确;治疗上应注重骨折的解剖复位及其有效固定;手术切口建议采用髌骨下弧型切口与膝关节前外侧切口相结合。

Clinical Analysis of The Fractures of Patellar and Lateral Condyle of Femur of the Same Limb

Objective：To investigate the clinical characteristic and therapeutic method of the fracture of patellar and lateral condyle of femur of the same limb.Methods：From January 2000 to April 2008,14 cases of the fracture of patellar and lateral condyle of femur of the same limb were treated by surgical operation.Patellar fractures were treated by tension band fixing technique or steel-wire circular suture technique,or cutting the end of patella and re-establishing the ligament of patella.The fractures of lateral condyle of femur were managed with the cancellous bone nails or Kirschner wires.Results：12 casas were followed-up.The average follow-up time was 13 monthes.According to Merchan＇s functional evauation,The articular function of the knee was excellent in 7 cases,good in 3 cases,fair in 1 case,poor in 1 case.Both he excellent and good rate was 83.3%.Conclusion：There was higher missed diagnosis rate of the fracture of patellar and lateral condyle of femur of the same limb in regional hospital.We should read the x-ray carefully before operation and take knee joint CT to the doubtful cases.We should think highly of anatomical reduction of the fractures and effecical fixation.Combination of circular incision under the patella and anterior-lareral incision of knee joint is recommended.