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动力髁螺钉(DCS)钢板系统治疗股骨远端骨折的疗效:跨越 15 年的单中心经验。

Outcomes of distal femoral fractures treated with dynamic condylar screw (DCS) plate system: a single centre experience spanning 15 years.

机构信息

Department of Orthopaedic and Trauma Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital Center, Abdelouahab Derraq Street, PB 40000, Marrakesh, Morocco.

出版信息

Pan Afr Med J. 2021 Apr 14;38:363. doi: 10.11604/pamj.2021.38.363.27524. eCollection 2021.

Abstract

INTRODUCTION

the dynamic condylar screw (DCS) plate is an angular stable fixation (95°) system for distal femur fractures that allows for the ability to apply compression across the femoral condyles. The aim of this study was to evaluate our experience treating distal femur fractures with this device and give the long-term outcome.

METHODS

a retrospective study was undertaken in our institution during the period from January 2002 to December 2016. A total number of 240 patients with distal femur fractures were managed using DCS plate system and included in the study. The mean follow-up period was 33 months (26 - 62 months). Clinico-radiological progression of fracture union as well as the functional outcome was studied.

RESULTS

most of the fractures were closed injuries in young male patients resulting from traffic accidents. The average time to union was 12.6 weeks (range 11 - 23). Eight patients (3.3%) suffered superficial infection. Five patients (2.1%) developed deep venous thrombosis. Delayed union was observed in nine cases (3.7%) and non union in six cases (2.5%). At final follow-up, the mean range of motion (ROM) of knee was 115.7° (100°-148°). The mean Knee Society Score (KSS) was 84.5 (59 - 94) and the mean Lysholm score was 88.6 (range, 61 - 96), translating to good clinical results.

CONCLUSION

our study conclusively establishes that excellent functional outcome can be achieved with DCS plate inserted with skilled surgical technique in distal femur fractures including the ones that are communited or occurring in osteoporotic bone with a negligible complication rates.

摘要

介绍

动力髁螺钉(DCS)钢板是一种用于治疗股骨远端骨折的角稳定固定(95°)系统,可实现对股骨髁施加加压的能力。本研究旨在评估我们使用该器械治疗股骨远端骨折的经验,并提供长期结果。

方法

在我们医院进行了一项回顾性研究,时间为 2002 年 1 月至 2016 年 12 月。共有 240 例股骨远端骨折患者采用 DCS 钢板系统进行治疗,纳入本研究。平均随访时间为 33 个月(26-62 个月)。研究了骨折愈合的临床和放射学进展以及功能结果。

结果

大多数骨折是年轻男性患者因交通事故导致的闭合性损伤。平均愈合时间为 12.6 周(范围为 11-23 周)。8 例(3.3%)发生浅表感染。5 例(2.1%)发生深静脉血栓形成。9 例(3.7%)出现延迟愈合,6 例(2.5%)出现不愈合。最终随访时,膝关节平均活动度(ROM)为 115.7°(100°-148°)。膝关节学会评分(KSS)平均为 84.5(59-94),Lysholm 评分平均为 88.6(范围为 61-96),表明临床结果良好。

结论

我们的研究明确表明,通过熟练的手术技术,在股骨远端骨折中插入 DCS 钢板,包括那些关节内或骨质疏松性骨折,可获得极好的功能结果,且并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0894/8308866/eb34f70ef42b/PAMJ-38-363-g001.jpg

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