Department of Orthopaedics, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China.
Orthop Surg. 2013 May;5(2):118-23. doi: 10.1111/os.12035.
Treatment of distal femoral fracture in post-polio patients is difficult because the bone is usually osteopenic, small and deformed. This retrospective study aimed to investigate the outcomes of distal femoral fracture in post-polio patients treated by locking compression plates (LCP).
The medical records of 19 post-polio patients (mean age 49 years at time of surgery) were reviewed and intraoperative data retrieved. Fracture union and callus formation were evaluated on radiographs taken at each postoperative visit. Functional outcome assessments included range of motion and Hospital for Special Surgery (HSS) score of the ipsilateral knee joint.
Sixteen femoral fractures occurred in the poliomyelitis-affected limbs. The mean duration of operation was 86 min and mean blood loss 120 mL. All fractures healed (mean, four months) but union was delayed in one. At the final follow-up 2 yrs after surgery, the mean range of knee flexion was 105° (range, 90°-130°), and mean HSS score 76 points (range, 60-93). There were no cases of nonunion, implant cutout, or other complications.
LCP provides stable fixation of distal femoral fractures in post-polio patients. Bony union and good functional outcomes are achieved, but delayed union and minimal callus may occur.
患有小儿麻痹后遗症的患者的股骨远端骨折的治疗较为困难，因为其骨骼通常骨质疏松、细小且畸形。本回顾性研究旨在探讨使用锁定加压钢板（LCP）治疗小儿麻痹后遗症患者股骨远端骨折的效果。
回顾了 19 例小儿麻痹后遗症患者（手术时的平均年龄为 49 岁）的病历，并获取了术中数据。在每次术后随访时通过 X 线片评估骨折愈合和骨痂形成情况。功能结果评估包括患侧膝关节的活动范围和纽约特种外科医院（HSS）评分。
16 例股骨骨折发生在小儿麻痹后遗症影响的肢体。手术的平均时间为 86 分钟，平均失血量为 120 毫升。所有骨折均愈合（平均 4 个月），但有 1 例延迟愈合。术后 2 年的最终随访时，膝关节屈曲的平均范围为 105°（范围 90°-130°），HSS 评分平均为 76 分（范围 60-93）。无不愈合、植入物穿出或其他并发症的病例。
LCP 为小儿麻痹后遗症患者的股骨远端骨折提供了稳定的固定。可实现骨性愈合和良好的功能结果，但可能会出现延迟愈合和少量骨痂。
