Pai Manjeswar Mukund, Kale Amit, Raithatha Harsh, Shah Shail
Orthopaedics, Dr. D.Y. (Dnyandeo Yashwantrao) Patil Medical College and Hospital, Pune, IND.
Cureus. 2023 Jan 25;15(1):e34182. doi: 10.7759/cureus.34182. eCollection 2023 Jan.
Introduction Distal femur fracture has been routinely fixed with a single lateral locking plate. This method of fixation in intra-articular distal femur fractures has proved to give a higher outcome of varus collapse as well as higher rates of mal-union due to inadequate fixation of the medial aspect of the distal femur. To address this drawback of single lateral plating, the use of medial assisted plating (MAP) has been introduced recently, which was proposed to give better stability to the medial fragments. This Is a prospective case series of 50 patients with distal femur fractures treated with dual plating. Materials and methods Fifty cases of patients with distal femur fractures were treated with dual plating between August 2020 and September 2022. Patients were followed up postoperatively till the third month, when patients were assessed clinically and radiologically. Range of motion of the knee, postoperative fracture displacement, limb shortening, and signs of union and infection were checked. Neer's scoring and Kolmet's scoring were used to grade the outcome for the patients. Results The mean age of the patients was 39. Only 12% of the cases were open fractures. Eighty-four percent of the cases did not have fixed flexion deformity (FFD) and only 4% had FFD of 15 degrees; 72% of the cases achieved flexion of the knee beyond 120 degrees. Eighty-four percent of patients had normal walking ability by the 12th week postoperatively; 16% of the cases had a postoperative displacement of more than 1.6 cm, with the maximum being 2.5 cm. Conclusion From the study, we have concluded that outcomes were better for fractures of distal femur when treated with dual fixation, probably due to superior fixation and earlier postoperative mobilization.
引言 股骨远端骨折通常采用单外侧锁定钢板固定。事实证明,这种用于关节内股骨远端骨折的固定方法会导致内翻塌陷发生率更高,并且由于股骨远端内侧固定不充分,骨不连发生率也更高。为了解决单外侧钢板固定的这一缺点,最近引入了内侧辅助钢板固定(MAP),该方法旨在为内侧骨折块提供更好的稳定性。这是一项对50例接受双钢板固定治疗的股骨远端骨折患者的前瞻性病例系列研究。
材料与方法 2020年8月至2022年9月期间,对50例股骨远端骨折患者采用双钢板固定治疗。术后对患者进行随访直至第三个月,在此期间对患者进行临床和影像学评估。检查膝关节活动范围、术后骨折移位情况、肢体短缩情况以及愈合和感染迹象。采用Neer评分和Kolmet评分对患者的治疗结果进行分级。
结果 患者的平均年龄为39岁。仅12%的病例为开放性骨折。84%的病例没有固定性屈曲畸形(FFD),只有4%的病例FFD为15度;72%的病例膝关节屈曲超过120度。84%的患者在术后第12周时步行能力正常;16%的病例术后移位超过1.6 cm,最大为2.5 cm。
结论 从该研究中我们得出结论,双钢板固定治疗股骨远端骨折的效果更好,这可能是由于固定效果更好以及术后更早进行活动。