Khursheed O, Wani M M, Rashid S, Lone A H, Manaan Q, Sultan A, Bhat R A, Mir B A, Halwai M A, Akhter N
Department of Orthopaedics, Government Medical College Srinagar (Hospital for bone and joint surgery Barzulla), Srinagar, 190005, Jammu and Kashmir, India.
Musculoskelet Surg. 2015 Aug;99(2):139-47. doi: 10.1007/s12306-014-0343-y. Epub 2014 Dec 14.
Fractures involving the femur in older adults are reasonably common. The aim of this study was to evaluate the results of MIPO technique using locking plates in geriatric patients for distal extra-articular femur fractures.
About 25 consecutive patients with distal extra-articular femur fractures aged 60 years and above were treated using locking plates and minimally invasive technique. Patients were studied prospectively over a period of 3 years. Parameters studied included patient demographics, fracture type, time taken for the surgery, time to union and any complications.
Mean age of patients was 66.5 years. Nineteen (76%) patients were females. Most of fractures in our study were type 33A2 fractures (64%). Average time to full weight bearing was 14.32 weeks, and fractures united at an average of 16.88 weeks. There were two (8%) patients with superficial infection, two (8%) with implant tenderness. One (4%) patient developed knee stiffness. Five (20%) patients had extension lag of average 5°. One (4%) patient sustained a peri-implant fracture at 2 months. None of the patients developed non-union or delayed union. According to criteria laid by Schatzker's and Lambert, excellent results were achieved in 22 (88%) patients.
Outcome of minimally invasive fixation of distal extra-articular femur fractures with locking plates in patients of age 60 years and above seems to be good with high union rate despite high prevalence of osteoporosis and comminution.
老年人股骨骨折相当常见。本研究旨在评估在老年患者中使用锁定钢板的微创接骨术（MIPO）治疗股骨远端关节外骨折的效果。
约25例连续的60岁及以上股骨远端关节外骨折患者采用锁定钢板和微创技术进行治疗。对患者进行了为期3年的前瞻性研究。研究参数包括患者人口统计学资料、骨折类型、手术时间、愈合时间及任何并发症。
患者平均年龄为66.5岁。19例（76%）为女性。本研究中大多数骨折为33A2型骨折（64%）。完全负重的平均时间为14.32周，骨折平均在16.88周愈合。有2例（8%）患者发生表浅感染，2例（8%）有植入物压痛。1例（4%）患者出现膝关节僵硬。5例（20%）患者有平均5°的伸直滞后。1例（4%）患者在2个月时发生植入物周围骨折。无患者发生骨不连或延迟愈合。根据Schatzker和Lambert制定的标准，22例（88%）患者取得了优异的结果。
对于60岁及以上的患者，采用锁定钢板微创固定股骨远端关节外骨折，尽管骨质疏松和粉碎性骨折的发生率较高，但愈合率高，效果似乎良好。
