CAJ | 학술논문

目的：探讨股骨髁上闭合性骨折合并坐骨神经损伤的创伤机制及治疗。方法选择自济南军区总医院骨创伤科2000年1月至2014年6月收治的股骨髁上骨折患者316例，分析本组共15例股骨髁上闭合性骨折合并坐骨神经损伤患者病情，并行手术治疗，采用复位固定术，坐骨神经探查，神经松解减压或束膜吻合，临床随访采用神经功能愈合标准(MCRR)进行恢复情况评估。结果本组15例患者术前肌电图检查结果表现为：9例患者神经传导速度轻度减慢、电位波幅轻度降低、潜伏期轻度延长者；其中8例患者术后随访神经恢复优4例，良3例，可1例。6例患者术前肌电图提示神经传导速度明显减慢、电位波幅明显降低、潜伏期明显延长。临床随访6个月~3年，按肌电图检查结果分组进行MCRR标准评分的结果，坐骨神经恢复情况：优6例，良4例，可3例，差2例。结论肌电图检查结合术中肉眼观察坐骨神经损伤程度对指导手术和判断预后有一定意义。
목적：탐토고골과상폐합성골절합병좌골신경손상적창상궤제급치료。방법선택자제남군구총의원골창상과2000년1월지2014년6월수치적고골과상골절환자316례，분석본조공15례고골과상폐합성골절합병좌골신경손상환자병정，병행수술치료，채용복위고정술，좌골신경탐사，신경송해감압혹속막문합，림상수방채용신경공능유합표준(MCRR)진행회복정황평고。결과본조15례환자술전기전도검사결과표현위：9례환자신경전도속도경도감만、전위파폭경도강저、잠복기경도연장자；기중8례환자술후수방신경회복우4례，량3례，가1례。6례환자술전기전도제시신경전도속도명현감만、전위파폭명현강저、잠복기명현연장。림상수방6개월~3년，안기전도검사결과분조진행MCRR표준평분적결과，좌골신경회복정황：우6례，량4례，가3례，차2례。결론기전도검사결합술중육안관찰좌골신경손상정도대지도수술화판단예후유일정의의。
Objective To investigate the mechanism and treatment of supracondylar femoral closed fracture associated with sciatic nerve injury. Methods 15 cases of supracondylar femoral closed fracture associated with sciatic nerve injury patients underwent surgical treatment. The fracture was taken reposition and fixation, sciatic nerve exploration, nerve decompression or fascicular suture. Results The occurrence of excellent nerve recovery was 6 cases, fair recovery was 4 cases, poor recovery was 3 cases, bad recovery was 2 cases. Conclusions Patients with supracondylar femoral closed fracture associated with sciatic nerve injury should underwent the surgery as soon as possible, with the operation of fracture reposition and fixation, sciatic nerve exploration, nerve decompression or fascicular suture, in order to obtain a better outcome. It has a positive effect in operation and prognosis on the electromyography with intraoperative visual observation of the extent of sciatic nerve injury.