Markmiller Max, Konrad Gerhard, Südkamp Norbert
Department Orthopädie und Traumatologie, Klinik für Traumatologie, Universitätsklinikum, Freiburg, Germany.
Clin Orthop Relat Res. 2004 Sep(426):252-7. doi: 10.1097/01.blo.0000141935.86481.ba.
We evaluated the functional and radiologic outcomes after stabilization of distal femoral fractures using the distal femoral nail and a less invasive stabilization system to determine if the new implants are superior to other implants (especially the condylar blade plate) regarding the rates of axial deviation, nonunion, and infection and if one of these new implants (Less Invasive Stabilization System, or distal femoral nail) is superior to the other. Two groups, each with 16 patients, were documented prospectively and the results were compared. To record the findings objectively, the Lysholm-Gillquist score was used. A conversion procedure was done in two patients in the plate group and one patient of the nail group. At the 1-year followup mobility of the knee was on average 110 degrees in the plate group and 103 degrees in the nail group. The Lysholm-Gillquist score did not show any significant differences between the groups. There were clinically relevant varus or outer rotation deviations in three patients in the plate group and two patients in the nail group. The two minimally invasive implants used were good in terms of technique and outcome for treatment of distal femoral fractures and did not differ significantly for epidemiology, fracture type, conversion procedures, infection rate, malalignments, and subjective and objective findings at the 1-year followup. They were also superior to the condylar plate in terms of infection and axial malalignments.
我们评估了使用股骨远端髓内钉和微创稳定系统固定股骨远端骨折后的功能和影像学结果,以确定这些新型植入物在轴向偏差、骨不连和感染发生率方面是否优于其他植入物(尤其是髁钢板),以及这两种新型植入物(微创稳定系统或股骨远端髓内钉)中的一种是否优于另一种。前瞻性记录了两组患者,每组16例,并比较了结果。为了客观记录结果,使用了Lysholm-Gillquist评分。钢板组有2例患者和髓内钉组有1例患者进行了转换手术。在1年随访时,钢板组膝关节平均活动度为110度,髓内钉组为103度。Lysholm-Gillquist评分在两组之间未显示出任何显著差异。钢板组有3例患者和髓内钉组有2例患者存在临床相关的内翻或外旋偏差。所使用的两种微创植入物在治疗股骨远端骨折的技术和结果方面良好,在1年随访时,在流行病学、骨折类型、转换手术、感染率、畸形愈合以及主观和客观结果方面无显著差异。在感染和轴向畸形愈合方面,它们也优于髁钢板。