Connolly J F
Instr Course Lect. 1987;36:428-37.
Since closed treatment is effective in 80% to 85% of distal femoral fractures, operative intervention is not recommended. Unnecessary surgery produces unwarranted complications. The cast-brace technique should be used in the first week or two after injury to prevent deformities commonly associated with distal femoral fractures. The thigh cast should be carefully molded well over the femoral condyles. Distal femoral traction is preferred to proximal tibial traction to correct fracture deformities. If the closed reduction technique is not satisfactory in the early period after injury, operative intervention can still be readily accomplished. Percutaneous pin fixation of the condyles or intramedullary load-sharing devices are the treatment of choice for the very limited number of fractures that require open reduction and internal fixation.
由于闭合治疗对80%至85%的股骨远端骨折有效，因此不建议进行手术干预。不必要的手术会产生不必要的并发症。在受伤后的头一两周应采用石膏支具技术，以预防通常与股骨远端骨折相关的畸形。大腿石膏应仔细塑形，覆盖股骨髁。矫正骨折畸形时，股骨远端牵引优于胫骨近端牵引。如果在受伤后的早期闭合复位技术不令人满意，仍可轻松完成手术干预。对于极少数需要切开复位内固定的骨折，髁部经皮穿针固定或髓内负荷分担装置是首选治疗方法。
