Orthopedic Surgery Department, Zagazig University Faculty of Medicine, Zagazig, Egypt.
Clin Orthop Surg. 2011 Jun;3(2):133-9. doi: 10.4055/cios.2011.3.2.133. Epub 2011 May 12.
This study evaluated the outcomes of surgical management of ipsilateral femoral and tibial fractures in adults.
Fifteen patients (13 men, 2 women; mean age, 34.8 years; range, 18 to 65 years) were enrolled in this study. The fractures types were classified according to the classification by Fraser et al. as follows: type I (5), type IIa (3), IIb (4), IIc (3). Femur fractures were treated using locked intramedullary nails, plate-screws, or dynamic condylar screws, and tibia fractures were treated with an external fixator (in open fractures), or plate-screws, and locked intramedullary nailing. The mean follow-up duration was 2.2 years (range, 1.3 to 4 years).
The extent of bony union according to the Karlstrom criteria was as follows: excellent, 8; good, 4; acceptable, 2; poor, 1.
The associated injuries and type of fracture (open, intra-articular, comminution) are prognostic factors in a floating knee. The best management of the associated injuries for good final outcome involves intramedullary nailing of both the fractures and postoperative rehabilitation.
本研究评估了成人同侧股骨和胫骨骨折的手术治疗结果。
本研究纳入了 15 名患者（13 名男性，2 名女性；平均年龄 34.8 岁；年龄范围 18 岁至 65 岁）。骨折类型根据 Fraser 等的分类如下：Ⅰ型（5 例）、Ⅱa 型（3 例）、Ⅱb 型（4 例）、Ⅱc 型（3 例）。股骨骨折采用锁定髓内钉、钢板螺钉或动力髁螺钉治疗，胫骨骨折采用外固定器（开放性骨折）或钢板螺钉和锁定髓内钉治疗。平均随访时间为 2.2 年（范围 1.3 至 4 年）。
根据 Karlstrom 标准，骨愈合程度如下：优 8 例，良 4 例，可 2 例，差 1 例。
浮动膝的预后因素与合并损伤和骨折类型（开放性、关节内、粉碎性）有关。为获得良好的最终结果，最好同时对两处骨折进行髓内钉固定，并进行术后康复。
