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埃塞俄比亚西北省巴哈达尔市提贝比格霍恩专科医院采用股骨远端锁定钢板切开复位内固定治疗股骨远端骨折的功能预后的前瞻性研究。

Prospective study on functional outcome of distal femur fracture treated by open reduction and internal fixation using distal femur locking plate in Tibebe Ghion Specialized Hospital, Bahirdar, North West Ethiopia.

机构信息

Department of Orthopedics and Trauma Surgery, College of Medicine and Health Science, Bahirdar University, Bahirdar, Ethiopia.

Department of Anatomy School of Medicine, College of Medicine and Health Science, Deberetabor University, Deberetabor, Ethiopia.

出版信息

J Orthop Surg Res. 2024 Sep 20;19(1):582. doi: 10.1186/s13018-024-05054-7.

DOI:10.1186/s13018-024-05054-7

PMID:39304870

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11414311/

Abstract

BACKGROUND

Distal femur fractures account for 6% of femur fractures. The treatment of distal femur fractures is challenging. Historically, nonoperative management has been the mainstay of management, which has evolved to operative management. There is no single implant used for all types of distal femur fractures. The implant evolves with time. The introduction of a distal femur locking plate (DF LCP) has had a great impact on the treatment. In developing countries like Ethiopia, there is scarcity of studies on functional outcome of operative treatment. So, this study aimed to assess the functional outcome of distal femur fractures treatment using distal femur locking plate.

METHODS

This prospective cohort study was carried out among adult patients with distal femur fractures treated using distal femur locking plate at Tibebe Ghion Specialized Hospital from august 2022 to July 2023. A total of 60 patients with AO Type A and Type C fracture were included. All patients were followed for 6 months. Functional outcomes were assessed using Neer's scoring system. Data was entered and analyzed using SPSS 27. Frequency, mean and cross tabulation were used to summarize descriptive statistics. Multinomial logistic regression was used to test the associations.

RESULTS

In our study out of 60 patients ,48.3% (29) had excellent functional outcomes, 30% (18) had good functional outcomes, 10% (6) had fair functional outcomes and 11.7% (7) had unsatisfactory functional outcomes according to Neer's scoring system. Patients with closed distal femur fractures had 5 times higher probability of excellent functional outcome than those patients with open distal femur fractures (AOR (2.49(5.8 ,1.07)). Patients who had regular follow up had 7 times higher probability of excellent functional outcome than those who had no regular follow up (AOR 7.16(1.11,46.22)). The average union period was 4.63 months, with only 2 patients experiencing delayed union.

CONCLUSION

Closed fracture and regular follow up were determining factors for better functional outcomes. Closed fractures preserve the biological environment, which facilitates early fracture healing. The regular follow up helped patients to assess their rehabilitation status and pick any complication early.

摘要

背景

股骨远端骨折占股骨骨折的 6%。股骨远端骨折的治疗具有挑战性。历史上，非手术治疗一直是主要的治疗方法，现已演变为手术治疗。没有一种植入物可用于所有类型的股骨远端骨折。植入物随时间而演变。股骨远端锁定钢板（DF LCP）的引入对治疗产生了重大影响。在埃塞俄比亚等发展中国家，关于手术治疗功能结果的研究很少。因此，本研究旨在评估使用股骨远端锁定钢板治疗股骨远端骨折的功能结果。

方法

这是一项前瞻性队列研究，在 2022 年 8 月至 2023 年 7 月期间，在提贝比·格洪专科医院对使用股骨远端锁定钢板治疗的成人股骨远端骨折患者进行了这项研究。共纳入 60 例 AO 型 A 型和 C 型骨折患者。所有患者均随访 6 个月。采用 Neer 评分系统评估功能结果。使用 SPSS 27 输入和分析数据。使用频率、平均值和交叉表对描述性统计数据进行总结。使用多项逻辑回归检验关联。

结果

在我们的研究中，60 名患者中有 48.3%（29 名）功能结果优秀，30%（18 名）功能结果良好，10%（6 名）功能结果尚可，11.7%（7 名）功能结果不满意。根据 Neer 评分系统，闭合性股骨远端骨折患者发生优良功能结果的可能性是开放性股骨远端骨折患者的 5 倍（优势比（2.49（5.8，1.07））。定期随访的患者发生优良功能结果的可能性是未定期随访的患者的 7 倍（优势比 7.16（1.11，46.22））。平均愈合期为 4.63 个月，仅有 2 例发生延迟愈合。