基层医学论坛
基層醫學論罈
기층의학론단
PUBLIC MEDICAL FORUM MAGAZINE
2015年
2期
145-147
,共3页
膝关节%粉碎性骨折%内固定%LISS
膝關節%粉碎性骨摺%內固定%LISS
슬관절%분쇄성골절%내고정%LISS
Knee%Comminuted fracture%Internal fixation%LISS
目的：探讨AO微创内固定系统（less invasive stabilization system，LISS）治疗膝关节周围严重粉碎性骨折的手术适应证及其疗效。方法2009年3月—2012年10月应用LISS钢板治疗膝关节周围严重粉碎性骨折23例，其中股骨骨折13例，胫骨骨折10例。合并髌骨骨折2例，伴其他部位骨折4例。按AO/OTA分型，股骨骨折中，33-A3型3例，33-C2型6例，33-C3型4例；胫骨骨折中，41-A3型3例，41-B2型4例，41-C2型3例。手术采用间接复位（关节内骨折除外），微创切口，经骨膜外和肌肉之间插入钢板，经皮小切口将带锁定头的螺钉与钢板的螺孔锁定。结果全部病例均获得随访，平均时间为15个月（12个月~24个月）。术后伤口均Ⅰ期愈合，1例骨延迟愈合。HSS评分：优17例，良3例，可2例，差1例，优良率86.9%。结论 LISS钢板治疗膝关节周围严重粉碎性骨折具有微创、固定可靠、术后恢复快和骨折愈合快的优点，是理想的内固定材料。明确手术适应证，严格掌握操作程序和重视对骨缺损的处理是取得满意疗效的关键。
目的：探討AO微創內固定繫統（less invasive stabilization system，LISS）治療膝關節週圍嚴重粉碎性骨摺的手術適應證及其療效。方法2009年3月—2012年10月應用LISS鋼闆治療膝關節週圍嚴重粉碎性骨摺23例，其中股骨骨摺13例，脛骨骨摺10例。閤併髕骨骨摺2例，伴其他部位骨摺4例。按AO/OTA分型，股骨骨摺中，33-A3型3例，33-C2型6例，33-C3型4例；脛骨骨摺中，41-A3型3例，41-B2型4例，41-C2型3例。手術採用間接複位（關節內骨摺除外），微創切口，經骨膜外和肌肉之間插入鋼闆，經皮小切口將帶鎖定頭的螺釘與鋼闆的螺孔鎖定。結果全部病例均穫得隨訪，平均時間為15箇月（12箇月~24箇月）。術後傷口均Ⅰ期愈閤，1例骨延遲愈閤。HSS評分：優17例，良3例，可2例，差1例，優良率86.9%。結論 LISS鋼闆治療膝關節週圍嚴重粉碎性骨摺具有微創、固定可靠、術後恢複快和骨摺愈閤快的優點，是理想的內固定材料。明確手術適應證，嚴格掌握操作程序和重視對骨缺損的處理是取得滿意療效的關鍵。
목적：탐토AO미창내고정계통（less invasive stabilization system，LISS）치료슬관절주위엄중분쇄성골절적수술괄응증급기료효。방법2009년3월—2012년10월응용LISS강판치료슬관절주위엄중분쇄성골절23례，기중고골골절13례，경골골절10례。합병빈골골절2례，반기타부위골절4례。안AO/OTA분형，고골골절중，33-A3형3례，33-C2형6례，33-C3형4례；경골골절중，41-A3형3례，41-B2형4례，41-C2형3례。수술채용간접복위（관절내골절제외），미창절구，경골막외화기육지간삽입강판，경피소절구장대쇄정두적라정여강판적라공쇄정。결과전부병례균획득수방，평균시간위15개월（12개월~24개월）。술후상구균Ⅰ기유합，1례골연지유합。HSS평분：우17례，량3례，가2례，차1례，우량솔86.9%。결론 LISS강판치료슬관절주위엄중분쇄성골절구유미창、고정가고、술후회복쾌화골절유합쾌적우점，시이상적내고정재료。명학수술괄응증，엄격장악조작정서화중시대골결손적처리시취득만의료효적관건。
Objective To investigate the AO Less Invasive Stabilization System (less invasive stabilization system, LISS) treatment of severe comminuted fractures around the knee and the efficacy of surgical indications. Method In March 2009-2012 years, in October applied around the LISS plate for treatment of severe comminuted fracture of the knee in 23 cases, including 13 cases of femoral fractures, tibial fractures in 10 cases. Combined patella fracture in 2 cases, with other parts of the fracture in 4 cases. According to AO/OTA classification, femur fractures , 33-A3 type 3 cases ,33-C2-type 6 cases ,33-C3 type 4 cases;tibial fractures ,41-A3 type 3 cases ,41-B2 type 4 cases, 41-C2-type 3 case. Use of indirect reduction surgery,Chong-dimensional incision, the periosteum and the muscles inserted between the outer steel plate,a small incision through the skin will take locking head screws with locking screw plate. Results All patients were followed up,with an average time of 15 months (12 to 24 months). Wound healed, and 1 case of delayed union of bone. HSS score:excellent in 17 cases, good in 3 cases, 2 case and poor in 1 case, good rate of 86.9%.Conclusion LISS plate for the treatment of severe comminuted around the knee with a minimally invasive,reliable fixation,postoperative recovery was quick and fast fracture healing advantages of the treatment of severe comminuted fractures around the knee the ideal fixation materials. Clear hand Surgery indications , strict control procedures and attention to the treatment of bone defects is the key to satisfactory effect.
