Henry S L
Department of Orthopaedic Surgery, University of Kentucky School of Medicine, Lexington, USA.
Clin Orthop Relat Res. 2000 Jun(375):51-9. doi: 10.1097/00003086-200006000-00007.
One hundred twenty-five supracondylar fractures in 118 patients treated with the Green-Seligson-Henry supracondylar intramedullary nail were evaluated. One hundred four patients (111 fractures) were followed up to fracture union. The percutaneous technique was compared with open reduction and internal fixation using the same device. The mean operative time was greater for the open reduction technique when compared with the percutaneous technique (176 minutes versus 76.6 minutes, respectively), as was the mean estimated blood loss (229 cc versus 96.2 cc). The incidence of delayed union was approximately the same for patients who were treated with both techniques. However, the nonunion rate was significantly higher in the patients treated with open reduction and internal fixation than the patients treated with the percutaneous technique (5.6% versus 2.6%). Twenty-nine (39%) patients who were treated with open reduction and internal fixation required bone grafting versus only three (7%) patients who were treated with the percutaneous technique. Additionally, the percutaneous technique did not produce a higher incidence of malalignment and resulted in a greater postoperative range of motion than the open technique. The current study shows that percutaneous treatment of supracondylar femur fractures is possible and can decrease operative times, blood loss, the need for bone grafting, increase rates of union, and improve functional outcomes.
对118例患者的125例股骨髁上骨折采用格林-塞利格森-亨利股骨髁上髓内钉治疗并进行评估。104例患者（111处骨折）随访至骨折愈合。将经皮技术与使用相同器械的切开复位内固定术进行比较。与经皮技术相比，切开复位技术的平均手术时间更长（分别为176分钟和76.6分钟），平均估计失血量也更多（229毫升和96.2毫升）。两种技术治疗的患者延迟愈合发生率大致相同。然而，切开复位内固定术治疗的患者不愈合率显著高于经皮技术治疗的患者（5.6%对2.6%）。切开复位内固定术治疗的29例（39%）患者需要植骨，而经皮技术治疗的患者只有3例（7%）需要植骨。此外，经皮技术并未导致更高的畸形发生率，且与切开技术相比，术后活动范围更大。当前研究表明，股骨髁上骨折的经皮治疗是可行的，可减少手术时间、失血量、植骨需求，提高愈合率，并改善功能结果。
