Massoud Elsayed Ibraheem Elsayed
Department of Orthopaedic, Sohag Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Sohag, Egypt.
Ulus Travma Acil Cerrahi Derg. 2015 May;21(3):197-203. doi: 10.5505/tjtes.2015.00490.
Most of healed lower femoral fractures resulted in various degree of loss of the knee motion. Flexion deficit is a serious problem for the Eastern persons that are where squatting and sitting on the ground are necessary for daily activities. The aims of this study were to compare outcomes of using condylar buttress plate and dynamic condylar screw (DCS) in treatment of distal femoral fractures. Secondly, we present our clinical experience for optimizing the technical application of the studied implants.
Two groups (plate and DCS) of 57 patients were treated for 59 lower femoral fractures with condylar buttress plate or DCS and followed prospectively for 24 months.
Plate group reported adequate reduction in 67% and varus angulation in 13.3% of the fractures. DCS group reported adequate reduction in 72.4% and posterior angulations in 17% of the fractures. Other reasons for inadequacy of reduction were reported in both groups. Full knee motion range was achieved in 50% of plate group and in 55% of DCS group. 75% and 90% satisfactory functional outcomes were reported in the plate and DCS groups respectively.
Both implants nearly achieved equal results concerning restoration of knee motion range. The condylar buttress plate and DCS are liable for technical optimization.
大多数已愈合的股骨下段骨折会导致不同程度的膝关节活动丧失。对于东方人来说，屈曲受限是一个严重的问题，因为在日常活动中蹲和坐在地上是必要的。本研究的目的是比较使用髁支持钢板和动力髁螺钉（DCS）治疗股骨远端骨折的疗效。其次，我们介绍我们在优化所研究植入物技术应用方面的临床经验。
两组（钢板组和DCS组）共57例患者接受了59例股骨下段骨折的治疗，分别使用髁支持钢板或DCS，并进行了为期24个月的前瞻性随访。
钢板组报告67%的骨折复位良好，13.3%的骨折出现内翻成角。DCS组报告72.4%的骨折复位良好，17%的骨折出现后凸成角。两组均报告了复位不充分的其他原因。钢板组50%的患者和DCS组55%的患者实现了膝关节全活动范围。钢板组和DCS组分别报告了75%和90%的满意功能结果。
两种植入物在恢复膝关节活动范围方面几乎取得了相同的结果。髁支持钢板和DCS都需要进行技术优化。
