Johnson E E
Division of Orthopaedic Surgery, Center for Health Sciences, University of California, Los Angeles 90024.
Clin Orthop Relat Res. 1988 Jun(231):154-62.
Five patients with identical severely comminuted four-part intraarticular T-type fractures of the distal femur were treated with a combination of direct reduction of the condylar anatomy and indirect reduction of the metaphyseal fragments using a 95 degree blade plate and femoral distractor. In all patients there was a coronal-axial fracture of the medial condyle anterior to the origin of the posterior cruciate ligament (PCL) associated with disruption of the patellofemoral articulation (four-part fracture). There were no associated intraarticular or extraarticular knee ligament injuries with this specific fracture pattern. Following fracture stabilization all knees were stable. Anatomic reduction of the articular surface and restoration of alignment were obtained in every case. Functional results were rated as good to excellent in all patients.
五名患有相同严重粉碎性四部分关节内股骨远端T型骨折的患者，采用髁部解剖直接复位和使用95度钢板及股骨撑开器对干骺端骨折块进行间接复位相结合的方法进行治疗。所有患者均存在后交叉韧带（PCL）起点前方的内侧髁冠状面-轴面骨折，并伴有髌股关节脱位（四部分骨折）。这种特定的骨折类型未伴有关节内或关节外膝关节韧带损伤。骨折固定后，所有膝关节均保持稳定。每例均实现了关节面的解剖复位和对线恢复。所有患者的功能结果评定为良好至优秀。
