From the Department of Orthopaedic Surgery, Indiana University School of Medicine, Indiana University Health Methodist Hospital (Dr. Virkus, Dr. Sorkin, and Dr. Gaski), and the Department of Orthopedic Surgery, Carolinas Medical Center, Charlotte, NC (Dr. Kempton).
J Am Acad Orthop Surg. 2018 Sep 15;26(18):629-639. doi: 10.5435/JAAOS-D-16-00849.
Plate fixation has historically been the preferred surgical treatment method for periarticular fractures of the lower extremity. This trend has stemmed from difficulties with fracture reduction and concerns of inadequate fixation with intramedullary implants. However, the body of literature on management of periarticular fractures of the lower extremities has expanded in recent years, indicating that intramedullary nailing of distal femur, proximal tibia, and distal tibia fractures may be the preferred method of treatment in some cases. Intramedullary nailing reliably leads to excellent outcomes when performed for appropriate indications and when potential difficulties are recognized and addressed.
钢板固定历来是治疗下肢关节周围骨折的首选手术治疗方法。这种趋势源于骨折复位的困难和对髓内植入物固定不足的担忧。然而，近年来关于下肢关节周围骨折处理的文献数量有所增加，表明在某些情况下，股骨远端、胫骨近端和胫骨远端骨折的髓内钉固定可能是首选治疗方法。在适当的适应证下，当认识到并解决潜在的困难时，髓内钉固定可靠地导致良好的结果。
