Higgins Thomas F
Department of Orthopedics, University of Utah, Salt Lake City, Utah, USA.
J Knee Surg. 2007 Jan;20(1):56-66. doi: 10.1055/s-0030-1248023.
Distal femoral fractures largely occur secondary to high-energy trauma in the younger population and as osteoporotic fractures in the elderly population, including periprosthetic fractures above a TKA. Attempts to gain satisfactory axial alignment, articular congruity, and knee range of motion with conservative treatment have been largely disappointing. Operative fixation options include open reduction and internal fixation, intramedullary nailing, and bridge plating or percutaneous submuscular plating techniques. As with any fracture, treatment choice must be individualized according to the nature of the injury, bone quality, and patient demand. Regardless of treatment method, goals include restoration of articular congruity, anatomical length, rotation, and axial alignment while establishing adequate fixation to initiate early and unrestricted range of motion.
股骨远端骨折在年轻人群中主要继发于高能创伤，而在老年人群中则为骨质疏松性骨折，包括全膝关节置换术（TKA）以上的假体周围骨折。通过保守治疗试图获得满意的轴向对线、关节一致性和膝关节活动范围，结果大多令人失望。手术固定方法包括切开复位内固定、髓内钉固定以及桥接钢板或经皮肌下钢板技术。与任何骨折一样，治疗选择必须根据损伤的性质、骨质和患者需求进行个体化。无论采用何种治疗方法，目标都包括恢复关节一致性、解剖长度、旋转和轴向对线，同时建立足够的固定以启动早期且不受限制的活动范围。
