Zehntner M K, Marchesi D G, Burch H B, Ganz R
Universitätsklinik für Orthopädische Chirurgie, Inselspital CH-3010 Bern.
Z Unfallchir Versicherungsmed. 1991;84(4):211-5.
Of 104 supra-/intercondylar femur fractures in adults (AO/ASIF Classification types A 1-3 and C 1-3), who were treated by open reduction and internal fixation from 1975 to 1985 59 fractures in 57 patients could be traced and reviewed clinically and radiographically after a mean follow-up period of 5 years and 7 months (range: 2-11 years). Among these, 47 knees/patients without preexisting knee-joint pathology were analyzed for the development of degenerative arthritis. The incidence for grade 2 and 3 changes in the femoropatellar compartment were 23% for supracondylar fractures (A type) and 62% for intercondylar lesions (C type). In the femorotibial compartment the incidence for supracondylar fractures was 38% and 23% for intercondylar fractures. In 93% of the patients the arthritic changes were radiographical findings, which did not cause relevant symptoms. The development of radiographical degenerative changes depends mainly on the type of the fracture; it is favoured by axial malalignment of more than 5 degrees of varus or valgus and local complications.
1975年至1985年间,104例成人股骨髁上/髁间骨折(AO/ASIF分类A1-3型和C1-3型)采用切开复位内固定治疗。对57例患者的59处骨折进行了随访,平均随访时间为5年7个月(范围:2至11年),进行了临床和影像学检查。其中,对47例无膝关节原有病变的膝关节/患者分析了退行性关节炎的发生情况。股骨髌股关节2级和3级改变的发生率,髁上骨折(A型)为23%,髁间骨折(C型)为62%。在股骨胫关节,髁上骨折的发生率为38%,髁间骨折为23%。93%的患者关节炎改变为影像学表现,未引起相关症状。影像学退行性改变的发生主要取决于骨折类型;内翻或外翻超过5度的轴向畸形和局部并发症会促进其发展。