CAJ | 학술논문

目的：探讨骨折区旷置内固定治疗股骨髁上严重粉碎骨折的有效性。方法总结分析自2005年1月至2008年12月间我科收治且经骨折区旷置手术治疗的股骨髁上严重粉碎骨折19例。其中AO分型中A3型11例，C2型8例；新鲜骨折15例，陈旧性骨折2例，骨折不愈合2例。开放性骨折3例，闭合性骨折16例。术中骨折区复位后，应用股骨髁支持钢板内固定，取自体髂骨或髂骨结合腓骨植入填充骨缺损区，对骨折区旷置不做内固定，于骨折区两侧以钉板内固定。结果19例患者手术经过顺利，术中出血260~800mL，伤口浅部感染延迟愈合1例，无其他并发症出现。随访19~50个月，复查X线片全部达到骨性愈合，愈合时间15~42周。HSS膝关节临床功能评分：优8例，良8例，可3例，差0例。结论骨折区旷置、植骨重建、钉板内固定是治疗股骨髁上严重粉碎骨折和防止并发症的有效方法。
목적：탐토골절구광치내고정치료고골과상엄중분쇄골절적유효성。방법총결분석자2005년1월지2008년12월간아과수치차경골절구광치수술치료적고골과상엄중분쇄골절19례。기중AO분형중A3형11례，C2형8례；신선골절15례，진구성골절2례，골절불유합2례。개방성골절3례，폐합성골절16례。술중골절구복위후，응용고골과지지강판내고정，취자체가골혹가골결합비골식입전충골결손구，대골절구광치불주내고정，우골절구량측이정판내고정。결과19례환자수술경과순리，술중출혈260~800mL，상구천부감염연지유합1례，무기타병발증출현。수방19~50개월，복사X선편전부체도골성유합，유합시간15~42주。HSS슬관절림상공능평분：우8례，량8례，가3례，차0례。결론골절구광치、식골중건、정판내고정시치료고골과상엄중분쇄골절화방지병발증적유효방법。
Objective?To discuss the efifcacy of reconstruction and ifxation exclusion and internal ifxations for complex supracondylar femoral fractures. Methods?A retrospectively studies were performed on 19 cases of complex supracondylar femoral fractures who had received operative treatment in our department from January 2005 to Dec 2008, their ages were from 26 to 59 years. There were 11 fractures of type A3 and 8 fractures of type C2 according to AO classiifcations. All patients obtained operation of reconstruction and ifxation exclusion and internal ifxations. Results?All operations were completed successfully. 19 cases were followed up from 19 to 50 months postoperatively to observe clinical efifcacy. 1 case was wound indolence because of infection and healed there weeks later. X-ray photos showed that all cases obtained fractures union at 15 to 42 weeks after operation. According to HSS score:8 cases were excellent, 8 good, 3 fair. Conclusion?The treatment of reconstruction and ifxation exclusion and internal ifxations were available in complex supracondylar femoral fractures.