Sanders R, Regazzoni P, Ruedi T P
Department of Orthopaedic Surgery, University of South Florida, Tampa.
J Orthop Trauma. 1989;3(3):214-22. doi: 10.1097/00005131-198909000-00006.
Forty-nine distal femur fractures were treated with the Dynamic Condylar Screw (DCS) between 1982 and 1985. The results in 35 fractures were reviewed in 32 patients with an average follow-up of 27.5 months. Functional results were graded using a stringent traumatic knee rating scale and Schatzker's criteria. The overall results were seen to be excellent to good in 71%, and excellent to good to fair in 83% of the cases. Using Müller's fracture classification, the less comminuted fractures were found to have better results than those with more comminution. Ease of insertion, the ability to obtain good fixation even in osteoporotic bone, and the capability of revising non-unions with a simple plate exchange are distinct advantages of the DCS over the 95 degree condylar blade plate. Medially placed iliac crest bone grafting should be performed if there is proximal extension of the fracture.
1982年至1985年间，49例股骨远端骨折采用动力髁螺钉（DCS）治疗。对32例患者的35处骨折结果进行了回顾，平均随访27.5个月。使用严格的创伤性膝关节评分量表和沙茨克标准对功能结果进行分级。71%的病例总体结果为优至良，83%的病例为优至良至尚可。采用米勒骨折分类法，发现粉碎程度较轻的骨折比粉碎程度较重的骨折结果更好。与95度髁钢板相比，DCS具有易于插入、即使在骨质疏松骨中也能获得良好固定以及通过简单的钢板置换修复骨不连的能力等明显优势。如果骨折向近端延伸，应进行髂嵴内侧植骨。
