Vangsness C T, DeCampos J, Merritt P O, Wiss D A
University of Southern California School of Medicine, Los Angeles.
J Bone Joint Surg Br. 1993 Mar;75(2):207-9. doi: 10.1302/0301-620X.75B2.8444938.
We studied 47 patients with closed, displaced, diaphyseal fractures of the femur caused by blunt trauma, to determine the incidence of associated knee injuries, particularly of the meniscus. After femoral nailing, all patients had an examination under anaesthesia and an arthroscopy. There were 12 medial meniscal injuries (5 tears) and 13 injuries of the lateral meniscus (8 tears). Ten of the 13 tears were in the posterior third of the meniscus, and two patients had tears of both menisci. Synovitis was common at the meniscal attachments. Complex and radial tears were more common than peripheral or bucket-handle tears. Examination under anaesthesia revealed ligamentous laxity in 23 patients (49%), but meniscal injuries had a similar incidence in knees with and without ligament injury. Femoral shaft fractures are often associated with injuries to the ipsilateral knee, and a high index of suspicion is necessary to identify these lesions.
我们研究了47例因钝性创伤导致的闭合性、移位性股骨干骨折患者，以确定相关膝关节损伤的发生率，尤其是半月板损伤的发生率。股骨钉固定术后，所有患者均接受了麻醉下检查和关节镜检查。内侧半月板损伤12例（5例撕裂），外侧半月板损伤13例（8例撕裂）。13例撕裂中有10例位于半月板后三分之一处，2例患者双侧半月板均有撕裂。半月板附着处滑膜炎很常见。复杂撕裂和放射状撕裂比周边撕裂或桶柄状撕裂更常见。麻醉下检查发现23例患者（49%）存在韧带松弛，但韧带损伤与否的膝关节中半月板损伤发生率相似。股骨干骨折常伴有同侧膝关节损伤，因此需要高度怀疑以识别这些损伤。
