|Table of Contents|

Efficacy of less invasive stabilization system fixation and double plating with anterior midline incision in treatment of AO-type C3 distal femoral fractures

(PDF)

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

Issue:
2017年第17期
Page:
1774-1779
Research Field:
临床医学
Publishing date:

Info

Title:

Efficacy of less invasive stabilization system fixation and double plating with anterior midline incision in treatment of AO-type C3 distal femoral fractures

Author(s):

BAO Wei FAN Yuanjun LI Zhengyun CHEN Zengang

Department of Orthopedics, People’s Hospital of Banan District, Chongqing, 401320, China

Keywords:

distal femoral fracture internal fixation anterior midline incision less invasive stabilization systems

PACS:
R683.42; R687.32
DOI:
-
Abstract:

Objective     To evaluate the efficacy of less invasive stabilization systems (LISS) fixation and double plating on the treatment of AO-type C3 distal femoral fractures via anterior midline approach. Methods    From June 2014 to March 2017, 18 cases of AO-type C3 distal femoral fractures treated in our department were recruited in this study. They were 12 males and 6 females, at a mean age of 19-62 years. There were 11 cases due to traffic accidents and 7 due to falls from heights. Six of them had open fractures and 12 had closed fractures. They all were treated with LISS fixation and double plating with anterior midline incision. Kolment and Wulff criteria were used to evaluate knee joint function after internal fixation at the last time of follow-up. Results     For all the subjects, the average operative time was 145 (110 to 200) min, and they were followed up for 17.5 (12 to 25) months. They all achieved primary wound healing, and had an average time of 22 (20 to 26) weeks for fracture healing. No nonunion, infection, osteomyelitis or injuries of nerves and arteries were observed. According to the results of Kolment and Wulff criteria for knee joint function evaluation, 6 of them got excellent, 9 good, 2 fair and 1 poor outcomes, with a rate of 83.33% for good and excellent outcomes. Conclusion    The treatment of type C3 distal femoral fractures via anterior middle approach of knee joint can fully reveal the articular surface of the femoral condyle. And the operative vision is clear, making it easy for anatomical reduction of articular surface fractures. Combined with LISS double locking plates fixation treatment, it can avoid the injury of soft tissue, and the fracture also be rigid fixation. Postoperative early functional exercise should be allowed to obtain good clinical results.

References:

[1]GWATHMEY F W Jr,JONESQuaidoo S M,Kahler D,et al.Distal femoral fractures:current concepts[J].J Am Acad Orthop Surg,2010,18(10):597-607.DOI:10.5435/00124635-201010000-00003.
[2]熊建义,王大平,肖建德,等.AO微创内固定系统在股骨远端及胫骨近端粉碎性骨折的应用[J].中国修复重建外科杂志,2006,20(7):702-705.DOI:10.3321/j.issn:1002-1892.2006.07.005.
XIONG J Y, WANG D P, XIAO J D, et al. Treatment of comminuted fractures at distal femur and proximal tibia with less invasive stabilization systems[J]. Chin J Repar Reconst Surg, 2006, 20(7): 702-705. DOI:10.3321/j.issn:1002-1892.2006.07.005.
[3]BEINGESSNER D, MOON E, BAREI D et al. Biomechanical analysis of the less invasive stabilization system for mechanically unstable fractures of the distal femur: comparison of titanium versus stainless steel and bicortical versus unicortical fixation[J]. Trauma. 2011 Sep,71(3):620-624.DOI:10.1097/TA. 0b013e31820337c4.
[4]SYED A A,AGARWAL M,GIANNOUDIS P V,el al.Distal femoral fractures:long-term outcome following stabilisation with the LISS[J]. Injury, 2004, 35(6): 599-607. DOI:10.1016/S0020-1383(03)00247-X.
[5]张名硕.股骨远端骨折治疗进展[J].国际骨科学杂志,2012,33(5):306-308.DOI:10.3969/j.issn.1673-7083.2012.05.008.
ZHANG M S. Progress on treatment of distal  femur fractures[J]. Int J Orthop, 2012, 33(5): 306-308. DOI:10.3969/j.issn.16737083.2012.05.008.
[6]SANDERS R,SWIONTKOWSKI M,ROSEN H, et al. Doubleplating of comminuted, unstable fractures of the distal part of the femur[J]. J Bone Joint Surg Am, 1991, 73(3): 341-346. DOI:10.2106/0000462319917303000004.
[7]MOORE T J,WATSON T,GREEN S A,et al. Complications of surgically treated supracondylar fractures of the femur[J].J J Trauma,1987,27(4):402-406. DOI:10.1097/00005373-198704000-00010.
[8]茹江英,刘璠, 王友华. 股骨髁部骨折四种内固定方法的疗效比较[J]. 中国骨与关节损伤杂志, 2006,21(10): 781-783. DOI:10.3969/j.issn.1672-9935.2006.10. 005.
RU J Y, LIU F, WANG Y H. A comparative analysis of clinical results of four internal fixation methods for femoral condylar fractures[J]. Chin J Bone Joint Injury, 2006, 21(10): 781-783. DOI:10.3969/j.issn.1672-9935.2006.10.005.
[9]HENDERSON C E,KUHL L L,FITZPATRICK  D C, et al.Locking plates for distal femur fractures :is there a problem with fracture healing[J].J Orthop Trauma,2011,25(Suppl 1): S8-14. DOI:10.1097/BOT. 0b013e3182070127.
[10]王剑,关雪刚,朱亚彬,等.微创内固定系统与髁动力加压钢板在股骨远端骨折治疗中的比较研究[J].中华创伤骨科杂志,2008,10(6):590-591. DOI:10.3760/cma.j. issn.16717600.2008.06.030.
WANG J, GUAN X G, ZHU Y B, et al. Less invasive stabilization system versus dynamic condylar screws in treatment of distal femoral fractures[J]. Chin J Orthop Trauma, 2008, 10(6): 590-591. DOI:10.3760/cma.j.issn.1671-7600.2008.06.030.
[11]龚伟华,孙月华,朱振安,等,微创技术治疗股骨远端骨折[J].中华创伤骨科杂志,2006,8(4):385-387. DOI:10. 3760/cma.j.issn.1671-7600.2006.04.025.
GONG W H, SUN Y H, ZHU Z A, et al. Fractures of distal femur managed by minimally invasive techniques[J]. Chin J Orthop Trauma, 2006, 8(4): 385-387. DOI:10.3760/cma.j.issn.16717600.2006.04.025.
[12]CHANTRAAPANICH  N,MAHAISAVARIYA  B, SIRIBODHI  P,et al. Geometric mismatch analysis of retrograde nail in the asian femur[J]. Surg Radiol Anat, 2011, 33(9): 755-761. DOI:10.1007/s00276-011-0813-y.
[13]HIERHOLZER C, VON RüDEN C, PTZEL T,et al. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis[J]. Orthop,2011,45(3): 243-250.DOI:10.4103/0019-5413.80043.
[14]APIVATTHAKAKUL T, CHIEWCHARNTANAKIT S. Minimally invasive plate osteosynthesis (MIPO) in the treatment of the femoral shaft fracture where intramedullary nailing is not indicated[J]. Int Orthop,2009,33(4):1119-1126.DOI:10.1007/s00264-008-0603-2.
[15]KAO F C, TU Y K, SU J Y, et al. Treatment of distal femoral fracture by minimally invasive percutaneous plate osteosynthesis : comparison between the dynamic condylar screw and the less invasive stabilization system[J].  J Orthop Trauma, 2009, 67(4): 719-726. DOI:10.1097/TA.0b013e318 19d9cb2.
[16]EHLINGER M, ADAN P, ABANE L, et al. Minimallyinvasive internal fixation of extraarticular distal femur fractures using a locking plate: tricks of the trade[J]. Orthop Traumatol Surg Res,2011(97):201-205.DOI: 10.1016/j.otsr.2010.11.004.
[17]SANDERS R,SWIONTKOWSKI M ,ROSEN H, et al. Double-plating of comminuted ,unstable fractures of the distal part of the femur[J]. J Bone Joint Surg Am,1991,73(3):341-346. DOI:10.2106/00004623-199173030-00004.
[18]孙庆华,赵东,杨龙彪,等 . 股骨远端骨折不同内固定方法的疗效分析[J]. 中国骨与关节损伤杂志,2011,26(12):1064-1066.DOI:CNKI:SUN:GGJS.0.2011-12-004.
SUN Q H, ZHAO D, YANG L B, et al. A comparative analysis of clinical results of different fixation methods for fractures of distal femur[J]. Chin J Bone Joint Injury, 2011, 26(12): 1064-1066. DOI:CNKI:SUN: GGJS.0.2011-12-004.
[19]KHALILAEL S,AYOUB M A. Highly unstable complex C3type distal femur fracture:can double plating via a modified olerud extensile approach be a standby solution[J]. J Orthop Traumatol,2012,13(4):179-188. DOI:10.1007/s10195-012-0204-0.
[20]马宁,夏江,赵宏谋,等. 单侧与双侧钢板内固定治疗股骨远端骨折的疗效对比[J]. 中国骨与关节损伤杂志,2012,27(12):1084-1086.DOI:CNKI:SUN:GGJS.0. 2012-12-009.
MA N, XIA J, ZHAO H M, et al. A comparative study of two treatment methods for comminuted distal femoral fractures[J]. Chin J Bone Joint Injury, 2012, 27(12): 1084-1086. DOI:CNKI:SUN:GGJS.0.2012-12-009.

Memo

Memo:
-
Last Update: 2017-09-05