Orthopaedic Medical Center, The Second Hospital of Jilin University, No 218, Lane Ziqiang, Nanguan District, Changchun, 130041, People's Republic of China.
Eur J Med Res. 2022 Mar 2;27(1):31. doi: 10.1186/s40001-022-00649-4.
Floating knee type IIC, according to Fraser's classification, is an uncommon severe injury that typically occurs in polytrauma. In such cases, intra-articular fracture and the high degree of comminution and deformity of the mid-distal femur make fixation challenging. The purpose of this study was to demonstrate that minimally invasive plate osteosynthesis (MIPO) technology can simplify these complex problems and improve patient prognosis.
A 38-year-old man injured his left leg in a car accident, causing pain, swelling, deformity, and limited mobility on his left knee and thigh, and two small open wounds were noted mainly of the anterior aspect of the mid-distal thigh. Physical examination and computed tomography angiography of the lower limb confirmed that there was no damage to the neurovascular system. The clinical diagnosis was closed intra-articular fracture of the proximal tibia, open intra-articular fracture of the distal femur with extension to the diaphysis, and a patellar fracture on the ipsilateral knee. The treatment strategy involved a locking plate system applying MIPO technology. Postoperative evaluation of the patient was satisfactory, with immediate functional exercise, full weight-bearing after three months, and return to daily activity without pain. Final follow-up taken 3 years after surgery showed good lower limb alignment and complete plasticity of the bone structure, by which time the patient showed good limb function.
Minimally invasive techniques can provide a simple and effective treatment for some complex fractures.
根据 Fraser 分类，Fraser ⅠIC 型浮膝为一种不常见的严重损伤，通常发生于多发创伤。在这种情况下，关节内骨折以及股骨中远端严重粉碎和畸形使固定极具挑战。本研究旨在证实微创接骨板固定术（MIPO）技术可简化这些复杂问题并改善患者预后。
一名 38 岁男性因车祸致左腿受伤，出现左膝和大腿疼痛、肿胀、畸形和活动受限，且大腿中远端前侧可见两处小的开放性伤口。下肢体格检查和 CT 血管造影确认无神经血管系统损伤。临床诊断为闭合性胫骨近端关节内骨折、开放性股骨远端关节内骨折延伸至骨干和同侧膝关节髌骨骨折。治疗策略为应用 MIPO 技术的锁定钢板系统。术后患者评估满意，可即刻进行功能锻炼，术后 3 个月完全负重，且可无痛恢复日常活动。术后 3 年的最终随访显示下肢对线良好，骨结构完全塑性，患者肢体功能良好。
微创技术可为某些复杂骨折提供简单有效的治疗。
