Wu Chi Chuan
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Acta Orthop Traumatol Turc. 2014;48(4):388-95. doi: 10.3944/AOTT.2014.3264.
The aim of this study was to evaluate the use of retrograde locked intramedullary nailing for the treatment of varus malunion occurring following condylar buttress plating (CBP) for femoral supracondylar fractures.
The study included 32 consecutive adult patients treated with retrograde locked nailing for varus malunion of femoral supracondylar fractures following CBP. Patient results were evaluated based on healing time, lower extremity alignment and knee functions.
Average follow-up was 2.8 (range: 1.1 to 5.6) years for the 27 of the 32 patients who completed follow-up. All osteotomy sites healed at an average of 4.0 (range: 3.5 to 5.0) months. Average preoperative varus knee deformity was 19.6° (range: 14° to 26°). Immediate postoperative varus knee deformity was an average of 0.4° (range: valgus 2° to varus 3°) (p<0.001). At the final follow-up, the varus knee deformity was an average of 1.5° (range: valgus 1° to varus 3°) (p<0.001). Satisfactory knee function in patients improved from 0% to 93% (p<0.001). There were no serious complications.
Retrograde locked nailing appears to be an excellent alternative for the treatment of varus malunion of femoral supracondylar fractures after CBP treatment. It is a simple technique with high satisfaction rates.
本研究旨在评估逆行交锁髓内钉治疗股骨髁上骨折采用髁支持钢板(CBP)固定后出现的内翻畸形愈合的疗效。
本研究纳入32例连续成年患者,这些患者均采用逆行交锁髓内钉治疗股骨髁上骨折CBP固定后出现的内翻畸形愈合。根据愈合时间、下肢对线情况和膝关节功能对患者结果进行评估。
32例患者中有27例完成随访,平均随访时间为2.8年(范围:1.1至5.6年)。所有截骨部位平均在4.0个月(范围:3.5至5.0个月)愈合。术前膝关节内翻畸形平均为19.6°(范围:14°至26°)。术后即刻膝关节内翻畸形平均为0.4°(范围:外翻2°至内翻3°)(p<0.001)。在末次随访时,膝关节内翻畸形平均为1.5°(范围:外翻1°至内翻3°)(p<0.001)。患者膝关节功能满意度从0%提高到93%(p<0.001)。未出现严重并发症。
逆行交锁髓内钉似乎是治疗CBP治疗后股骨髁上骨折内翻畸形愈合的一种极佳替代方法。这是一种操作简单且满意度高的技术。