髓内钉在浮动膝盖上:一系列病例

Telmo Iván Tapia Peña, Juan-Claude Tapia Abril
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摘要

背景:“浮动膝”是指股骨和胫骨同侧骨折,其中膝关节与肢体的其余部分断开。这种机制通常是高能创伤。感染、不愈合、膝关节僵硬、失血过多、脂肪栓塞的发生率相对较高;导致功能损伤,结果往往不令人满意。髓内钉立即固定骨折可减少并发症的发生。方法:对7例经SIGN髓内钉(IMN)治疗的患者进行描述性研究;目的在临床实践中探讨该钉的功能效果、伴随损伤、并发症及优势。结果:患者以男性为主,平均年龄26岁。所有损伤均为交通事故所致,50%为外露性骨折。根据Blake & McBryde的分类,6例为I型,1例为IIa型。功能结果按照Karlström和Olerud标准进行评价;85%的病例获得优良率。所有骨折都愈合了;报告1例浅表感染,1例肢体缩短< 3cm,膝关节活动范围轻微受限。结论:SIGN髓内钉是治疗成人浮动膝的一种有效、通用的方法。术后功能效果良好(85%),并发症发生率低。关键词:浮动膝,股骨骨折,胫骨骨折,骨折固定,髓内固定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clavo Intramedular de Sign en Rodilla Flotante: Una serie de casos
BACKGROUND: “Floating knee” describes ipsilateral fractures of the femur and tibia, where the knee is disconnected from the rest of the limb. The mechanism is usually a high-energy trauma. Rates of infection, lack of union, stiffness of the knee, excessive blood loss, fat embolism, are relatively high; leading to functional impairment and often unsatisfactory results. Immediate definitive reduction and fixation of fractures by intramedullary nail reduces the incidence of complications. METHODS: A descriptive study was carried out, a case series report of 7 patientes treated by the SIGN Intramedullary Nail (IMN); to establish the functional results, concomitant injuries, complications and advantages of this nail, in our practice. RESULTS: The majority of the patients were male, with a mean age of 26 years. All injuries were caused in traffic accidents, 50% of the fractures were exposed fractures. According to the Blake & McBryde classification, 6 were Type I and one case Type IIa. Functional results were evaluated according to the Karlström and Olerud criteria; excellent and good results were obtained in 85% of cases. All of the fractures healed; one case of superficial infection was described, one patient presented limb shortening <3 cm and minor limitation of the knee motion range. CONCLUSION: The SIGN intramedullary nail, was efficient and versatile for the treatment of floating knee in adults. It had good functional results (85%) and low incidence of complications. KEYWORDS: FLOATING KNEE, FEMUR FRACTURE, TIBIAL FRACTURE, FRACTURE FIXATION, INTRAME-DULLARY.
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