Lupescu Olivera, Nagea Mihail, Patru Cristina, Vasilache Cornelia, Popescu Gheorghe Ion
Clinic of Orthopedics and Traumatology, Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Clinic of Orthopedics and Traumatology, Clinical Emergency Hospital, Bucharest, Romania.
Maedica (Bucur). 2015 Jun;10(2):117-122.
Due to their high complication rate and negative impact of those complications upon the knee and the whole lower limb, distal femoral fractures require optimal restoration of the functional anatomy and stable fixation thus allowing early recovery. This paper presents the experience of the authors regarding the indications and results of the most accepted surgical methods, including late complications affecting the knee.
36 patients with closed distal femoral fractures (21-81 yrs old) operated in Bucharest, Clinical Emergency Hospital, Orthopedics and Trauma Clinic, were retrospectively studied from the point of view of the fracture and implant type, functional results and complications.
Most of the fractures were high energy comminuted fractures (27 cases), mainly with articular involvement. Retrograde nail was used in type A fractures, while plating (LCP) was the main indication for type C fractures. The functional outcome was correlated with the fracture type and the incidence of complications was higher in type A3, C2 and C3 fractures.
Anatomical reduction of the articular surface, restoration of functional anatomy and stable fixation are mandatory for an optimal knee function after distal femoral fractures. Failure to achieve them, due to the character of the fracture or to improper fixation, is followed by significant functional deficit, thus delaying the patients' recovery.
由于股骨远端骨折的高并发症发生率以及这些并发症对膝关节和整个下肢的负面影响,需要对功能解剖结构进行最佳恢复并进行稳定固定,从而实现早期康复。本文介绍了作者在最常用手术方法的适应症和结果方面的经验,包括影响膝关节的晚期并发症。
对在布加勒斯特临床急诊医院骨科与创伤诊所接受手术的36例闭合性股骨远端骨折患者(年龄21 - 81岁)进行回顾性研究,内容包括骨折和植入物类型、功能结果及并发症。
大多数骨折为高能量粉碎性骨折(27例),主要累及关节。A型骨折采用逆行髓内钉,而C型骨折主要采用钢板固定(锁定加压钢板)。功能结果与骨折类型相关,A3、C2和C3型骨折的并发症发生率更高。
对于股骨远端骨折后实现最佳膝关节功能而言,关节面的解剖复位、功能解剖结构的恢复以及稳定固定是必不可少的。由于骨折的特点或固定不当未能实现这些目标,会导致明显的功能缺陷,从而延迟患者的康复。