Obey Mitchel R, Weick Jack W, Falgons Christian G, Achor Timothy S, Warner Stephen J
Department of Orthopaedic Surgery, Orthopaedic Trauma Service, Washington University in St. Louis, 660 S. Euclid, Campus, Box 8233, St. Louis, MO, 63110, USA.
Department of Orthopaedic Surgery, Grant Medical Center, Columbus, OH, USA.
Eur J Orthop Surg Traumatol. 2024 May;34(4):2073-2079. doi: 10.1007/s00590-024-03899-6. Epub 2024 Mar 26.
Intra-articular distal femur fractures in patients with a lower extremity amputation can present a technical challenge for the treating surgeon in what may be otherwise considered a routine procedure in non-amputees. Difficulties with positioning, fracture reduction, limb contractures, and stump osteoporosis can present challenges with treatment. Here, we describe the surgical technique and outcome of a case series of amputee patients with AO/OTA 33C femur fractures.
Retrospective case series of five patients with a comminuted supracondylar distal femur fracture with intercondylar extension proximal to a below-knee amputation treated with retrograde intramedullary nail at a single Level 1 trauma center from January 1, 2021, to January 1, 2023. Baseline demographic and clinical data were recorded. Rate of bony union and complications were documented.
Five patients (three females and two males) with a mean age of 48 years who were treated for a comminuted supracondylar distal femur fracture with intercondylar extension proximal to a below-knee amputation were identified. At the time of final follow-up (mean 109.3 days, range 29-183 days), all patients had healed their incisions and were progressing to return of function with their prosthesis. All patients were treated with the surgical technique described in this article, and no postoperative complications were reported.
This is an effective and safe technique for surgical treatment of comminuted intra-articular distal femur fractures in patients with an ipsilateral below-knee amputation. We believe that this technique can be utilized by any orthopedic surgeon taking trauma call and can avoid unnecessary transfers or delays to care.
对于下肢截肢患者，股骨远端关节内骨折对于治疗外科医生而言可能是一项技术挑战，而在非截肢患者中这可能被视为常规手术。定位困难、骨折复位困难、肢体挛缩和残端骨质疏松都会给治疗带来挑战。在此，我们描述了一组AO/OTA 33C型股骨骨折的截肢患者的手术技术及结果。
回顾性病例系列研究，纳入2021年1月1日至2023年1月1日在一家一级创伤中心接受逆行髓内钉治疗的5例膝关节以下截肢近端髁上股骨粉碎性骨折并伴有髁间延伸的患者。记录基线人口统计学和临床数据。记录骨愈合率和并发症情况。
确定了5例患者（3例女性和2例男性），平均年龄48岁，均接受了膝关节以下截肢近端髁上股骨粉碎性骨折并伴有髁间延伸的治疗。在末次随访时（平均109.3天，范围29 - 183天），所有患者切口均已愈合，且佩戴假肢功能恢复进展良好。所有患者均采用本文所述手术技术治疗，未报告术后并发症。
这是一种治疗同侧膝关节以下截肢患者股骨远端关节内粉碎性骨折的有效且安全的技术。我们认为，任何负责创伤救治的骨科医生均可采用该技术，且可避免不必要的转诊或延误治疗。
