Pettine K A
Orthopaedic Center of the Rockies, Ft. Collins, Colorado.
Contemp Orthop. 1990 Sep;21(3):253-61.
Twenty-nine patients were evaluated a minimum of ten years (average: 16 years) after femoral supracondylar fracture. Fracture type, mechanism of injury, and age of 14 patients initially treated nonoperatively were similar to those of 15 patients treated with nonrigid internal fixation. Complications were more common and more severe in the surgically-treated group. Knee range of motion remained permanently decreased in both groups, averaging 3 degrees lack of extension to 63 degrees of flexion. In both groups, 60% had symptoms of knee pain, instability, and gait abnormalities. Long-term poor results were caused by degenerative arthritis or loss of knee motion (or both). Degenerative arthritis developed in patients whose fracture healed with articular incongruity, greater that 15 degrees of valgus, any amount of varus, or a loss of normal mechanical axis. Results were satisfactory in seven of 15 patients in the surgical group and eight of 14 in the nonoperative group.
对29例股骨髁上骨折患者进行了至少十年（平均16年）的评估。14例最初接受非手术治疗患者的骨折类型、损伤机制和年龄与15例接受非刚性内固定治疗患者的相似。手术治疗组的并发症更常见且更严重。两组患者的膝关节活动范围均持续减小，平均伸直受限3度，屈曲63度。两组中，60%的患者有膝关节疼痛、不稳定和步态异常的症状。长期效果不佳是由退行性关节炎或膝关节活动丧失（或两者兼有）所致。骨折愈合时伴有关节不匹配、外翻大于15度、任何程度的内翻或正常机械轴丧失的患者发生了退行性关节炎。手术组15例患者中有7例结果满意，非手术组14例患者中有8例结果满意。
