tailieunhanh - Gãy xương cùng bên của xương đùi

Gãy xương cùng bên của xương đùi và xương chày đã được gọi là "nổi đầu gối" chấn thương và có thể bao gồm sự kết hợp của diaphyseal, metaphyseal, và gãy xương khớp nội bộ. Đây là những thường thương tích năng lượng cao và thường xuyên nhất xảy ra ở bệnh nhân polytrauma. Nhiều người trong số các gãy xương được mở, với chấn thương mạch máu liên quan. | Floating Knee Injuries Ipsilateral Fractures of the Femur and Tibia Douglas W. Lundy MD and Kenneth D. Johnson MD Abstract Ipsilateral fractures of the femur and tibia have been called floating knee injuries and may include combinations of diaphyseal metaphyseal and intra-articular fractures. These are often high-energy injuries and most frequently occur in the polytrauma patient. Many of these fractures are open with associated vascular injuries. Surgical stabilization of both fractures and early mobilization of the patient and the extremity produce the best clinical outcomes. The use of a radiolucent operating room table and the introduction of retrograde intramedullary fixation of femoral fractures have facilitated surgical stabilization of some floating-knee fracture patterns. Although treatment planning for each fracture in the extremity should be considered individually to achieve the optimal result the effect of that decision must be considered in light of the overall injury status of the entire extremity. Collateral ligament and meniscal injuries may also be associated with this fracture complex. Complications such as compartment syndrome loss of knee motion failure to diagnose knee ligament injury and the need for amputation are not infrequent. Better results and fewer complications are observed when both fractures are diaphyseal than when one or both are intra-articular. J Am Acad Orthop Surg 2001 9 238-245 In 1975 Blake and McBryde1 coined the term floating knee to describe the injury pattern of ipsilateral femoral and tibial fractures that disconnect the knee from the remainder of the extremity. This term is usually applied to the combination of diaphyseal femoral and tibial shaft fractures but may be used to describe ipsilateral hip and ankle fractures. Various methods of treating these injuries have been described ranging from traction2 to surgical Blake and Mc-Bryde were the first to document the results of operative treatment of this .