Ritter M A, Keating E M, Faris P M, Meding J B
Center for Hip and Knee Surgery, Mooresville, Indiana, USA.
J Arthroplasty. 1995 Apr;10(2):213-6. doi: 10.1016/s0883-5403(05)80130-5.
The authors report on 22 displaced supracondylar femur fractures and total knee arthroplasties treated with Rush rod (Berivon, Meridian, MI) fixation. The average age at the time of total knee arthroplasty was 67 years. Fractures occurred at an average of 5 years after surgery. In only five cases was notch in the anterior cortex noted. The follow-up period averaged 7 years. There were no nonunions. All knees healed between 3 and 4 months after surgery. Postoperative flexion averaged 108 degrees (preoperative average, 102 degrees). Only two knees demonstrated a flexion contracture before surgery (5 degrees-10 degrees), and both had flexion contractures after surgery as well (each 10 degrees). All other knees achieved full extension. The average alignment prior to fracture was 7 degrees of anatomic valgus. At the most recent follow-up evaluation this averaged 10 degrees with two knees in 15 degrees of valgus. The only complications noted were two intraoperative technical errors. No postoperative complications occurred. For supracondylar fractures above a total knee arthroplasty, the authors suggest closed reduction, Rush supracondylar rod fixation, early range of motion, and protected weight bearing until fracture healing. In all cases, an extensive surgical procedure was not required.
作者报告了22例采用Rush棒（Berivon，Meridian，密歇根州）固定治疗的股骨髁上移位骨折和全膝关节置换术。全膝关节置换术时的平均年龄为67岁。骨折平均发生在手术后5年。仅5例在前侧皮质有切迹。随访期平均为7年。无骨不连。所有膝关节均在术后3至4个月愈合。术后平均屈曲度为108度（术前平均为102度）。术前仅2例膝关节有屈曲挛缩（5度至10度），术后这2例也有屈曲挛缩（均为10度）。所有其他膝关节均达到完全伸直。骨折前的平均对线为7度解剖外翻。在最近的随访评估中，平均为10度，2例膝关节外翻15度。仅发现2例术中技术失误这一并发症。无术后并发症发生。对于全膝关节置换术以上的髁上骨折，作者建议采用闭合复位、Rush髁上棒固定、早期活动范围以及在骨折愈合前进行保护性负重。在所有病例中，均无需进行广泛的手术操作。
