Senthil Kannan Venkatesan, Sivakumar Singanallur Palanivelayutham, Dheenadhayalan Jayaramaraju, Rajasekaran Shanmuganathan
Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Private Limited, Coimbatore, Tamil Nadu, India.
J Clin Orthop Trauma. 2025 Mar 17;65:102979. doi: 10.1016/j.jcot.2025.102979. eCollection 2025 Jun.
Post-polio syndrome (PPS) can significantly alter lower limb anatomy and function. Femur is the most commonly fractured bone in post-polio patients. This study aimed to investigate the surgical challenges, fixation techniques employed, and functional outcomes in PPS patients with femoral fractures.
A retrospective analysis was conducted on 38 PPS patients diagnosed with femoral fractures. We assessed the underlying injury mechanism, anatomical variations (e.g., valgus neck deformity, hypoplastic greater trochanter, narrow canal, fixed knee flexion), and employed fixation techniques. Union time and functional recovery were evaluated.
Trivial falls were the most frequent cause of fracture. Notably, various anatomical variations were observed, potentially influencing treatment strategies. Intramedullary nailing was the preferred fixation method; however, some cases necessitated alternative extramedullary fixation techniques due to anatomical constraints. The average time for fracture union was 24 weeks, with all patients regaining their pre-fracture functional status.
Femoral fracture management in PPS patients requires meticulous consideration of unique anatomical challenges and patient-specific factors. A multidisciplinary approach emphasizing preoperative planning, intraoperative adaptability in fixation techniques, and comprehensive postoperative rehabilitation is crucial for optimal outcomes and minimizing complications.
小儿麻痹后遗症（PPS）可显著改变下肢的解剖结构和功能。股骨是小儿麻痹后遗症患者最常发生骨折的部位。本研究旨在探讨小儿麻痹后遗症合并股骨骨折患者的手术挑战、所采用的固定技术及功能预后。
对38例诊断为股骨骨折的小儿麻痹后遗症患者进行回顾性分析。我们评估了潜在的损伤机制、解剖变异（如颈外翻畸形、大转子发育不全、髓腔狭窄、膝关节固定性屈曲）以及所采用的固定技术。评估了骨折愈合时间和功能恢复情况。
轻微跌倒为最常见的骨折原因。值得注意的是，观察到多种解剖变异，可能影响治疗策略。髓内钉固定是首选的固定方法；然而，由于解剖学限制，一些病例需要采用其他髓外固定技术。骨折平均愈合时间为24周，所有患者均恢复至骨折前的功能状态。
小儿麻痹后遗症患者的股骨骨折治疗需要仔细考虑独特的解剖学挑战和患者的具体因素。强调术前规划、术中固定技术的适应性以及全面的术后康复的多学科方法对于实现最佳预后和减少并发症至关重要。
