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应用拉力螺钉和胫骨近端钢板治疗股骨内侧髁骨折:1例报告

Surgical treatment of femoral medial condyle fracture with lag screws and proximal tibial plate: A case report.

作者信息

Kodama Hiroyasu, Saku Isaku, Tomoyama Shin

机构信息

Department of Orthopaedic Surgery, Yaizu City Hospital, Shizuoka, Japan.

出版信息

Int J Surg Case Rep. 2020;70:101-105. doi: 10.1016/j.ijscr.2020.04.060. Epub 2020 May 11.

Abstract

INTRODUCTION

Femoral medial condyle fracture is a rare fracture. Here, we report a case of femoral medial condyle fracture treated with lag screws and proximal tibial plate as a buttress plate.

CASE PRESENTATION

A 80-year-old woman fell down 15 steps at her home and reported to our hospital with severe right knee pain. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Two days after injury, we performed open reduction and internal fixation using locking compression plate for proximal tibia and screws. The patient had an uneventful postoperative recovery. At the latest follow-up, the patient achieved a range of motion of 0° to 120° and could walk without pain.

DISCUSSION

Femoral medial condyle fracture is a rare fracture. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. Nevertheless, there are no available anatomical plates that fit either the femoral medial condyle or fracture fixation, except for the relatively short plate developed for distal femoral osteotomy. We used a locking compression plate - proximal tibial plate 4.5/5.0 (Depuy Synthes TRAUMA) as a buttress plate. The implant fitted well and enhanced joint stability. Postoperative radiographs confirmed anatomical reduction, and the patient achieved a good result.

CONCLUSION

The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture.

摘要

引言

股骨内侧髁骨折是一种罕见的骨折。在此,我们报告一例采用拉力螺钉和近端胫骨钢板作为支撑钢板治疗的股骨内侧髁骨折病例。

病例介绍

一名80岁女性在家中从15级台阶上摔倒,因右膝剧痛前来我院就诊。X线片和计算机断层扫描显示右膝股骨内侧髁骨折(AO分类:33 - B2)。受伤两天后,我们使用近端胫骨锁定加压钢板和螺钉进行切开复位内固定。患者术后恢复顺利。在最近的随访中,患者膝关节活动范围达到0°至120°,且能无痛行走。

讨论

股骨内侧髁骨折是一种罕见的骨折。与任何关节损伤一样,必须实现关节面的解剖复位,然后需要拉力螺钉固定。在存在垂直骨折线的骨折中,需要支撑钢板来抵消垂直剪切力。然而,除了为股骨远端截骨术开发的相对较短的钢板外,没有适合股骨内侧髁或骨折固定的解剖钢板。我们使用锁定加压钢板——4.5/5.0近端胫骨钢板(德普伊辛迪斯创伤公司)作为支撑钢板。该植入物适配良好,增强了关节稳定性。术后X线片证实解剖复位,患者取得了良好的效果。

结论

近端胫骨锁定加压钢板是治疗股骨内侧髁骨折的一种可接受的解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b28/7226634/25404f2a6b18/gr1.jpg

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