Choi Nam-Yong, Sohn Jong-Min, Cho Sung-Gil, Kim Seung-Chan, In Yong
Department of Orthopaedic Surgery, St. Paul's Hospital, Seoul, Korea.
Knee Surg Relat Res. 2013 Sep;25(3):141-6. doi: 10.5792/ksrr.2013.25.3.141. Epub 2013 Aug 29.
Primary total knee arthroplasty (TKA) can be an alternative method for treating distal femoral fractures in elderly patients with knee osteoarthritis. The purpose of this study was to evaluate the clinical and radiographic results in patients with knee osteoarthritis who underwent TKA with the Medial Pivot prosthesis for distal femoral fractures.
Eight displaced distal femoral fractures in 8 patients were treated with TKA using the Medial Pivot prosthesis and internal fixation. The radiographic and clinical evaluations were performed using simple radiographs and Hospital for Special Surgery (HSS) knee scores during a mean follow-up period of 49 months.
All fractures united and the mean time to radiographic union was 15 weeks. The mean range of motion of the knee joint was 114.3° and the mean HSS knee score was 85.1 at the final follow-up.
Based on the radiographic and clinical results, TKA with internal fixation can be considered as an option for the treatment of simple distal femoral fractures in elderly patients who have advanced osteoarthritis of the knee with appropriate bone stock.
对于患有膝关节骨关节炎的老年患者，初次全膝关节置换术（TKA）可作为治疗股骨远端骨折的一种替代方法。本研究的目的是评估采用内侧旋转平台假体治疗股骨远端骨折的膝关节骨关节炎患者的临床和影像学结果。
8例患者的8处移位性股骨远端骨折采用内侧旋转平台假体行TKA及内固定治疗。在平均49个月的随访期内，使用普通X线片和特殊外科医院（HSS）膝关节评分进行影像学和临床评估。
所有骨折均愈合，影像学愈合的平均时间为15周。末次随访时膝关节的平均活动范围为114.3°，HSS膝关节平均评分为85.1分。
基于影像学和临床结果，对于有合适骨量的晚期膝关节骨关节炎老年患者，TKA联合内固定可被视为治疗单纯股骨远端骨折的一种选择。
