Beltran Michael J, Gary Joshua L, Collinge Cory A
*Department of Orthopaedics and Rehabilitation, San Antonio Military Medical Center, Fort Sam Houston, TX; †Orthopaedic Specialty Associates, Fort Worth, TX; and ‡University of Texas Health Science Center, Houston, TX.
J Orthop Trauma. 2015 Apr;29(4):165-72. doi: 10.1097/BOT.0000000000000302.
Fractures of the distal femur, even those with articular extension, are well suited to surgical fixation with modern precontoured anatomic plates and nails. Numerous adjuvant techniques are available to the treating surgeon to obtain and maintain reduction while preserving fracture biology. Yet despite their proven track record and benefits over older implants, technical errors are common and must be overcome with proper preoperative planning and intraoperative attention to detail. This review summarizes the current state of the art regarding distal femur fractures, with an emphasis on relevant modern plate and nail surgical techniques, tempered by our current understanding of implant biomechanics, fracture healing, and long-term outcomes.
股骨远端骨折，即使是那些伴有关节面延伸的骨折，也非常适合使用现代预塑形解剖钢板和髓内钉进行手术固定。治疗外科医生可采用多种辅助技术来实现并维持骨折复位，同时保留骨折部位的生物学特性。然而，尽管这些现代植入物相较于老式植入物有着已被证实的良好记录和优势，但技术失误仍很常见，必须通过术前的合理规划以及术中对细节的关注来加以克服。本综述总结了股骨远端骨折的当前技术水平，重点介绍了相关的现代钢板和髓内钉手术技术，并结合我们目前对植入物生物力学、骨折愈合及长期疗效的理解进行阐述。
