Marks D S, Isbister E S, Porter K M
Birmingham Accident Hospital, Wolverhampton, England.
J Bone Joint Surg Br. 1994 Jul;76(4):596-601.
We report 33 cases of femoral supracondylar fracture in elderly or debilitated patients treated by Zickel supracondylar nails. Most of the patients were female and their mean age was 79 years. All had concurrent medical problems and only nine could walk unaided. The operating time averaged one hour and mean blood loss was 100 ml. Postoperative management was by mobilisation in a cast brace or plaster. Six patients died before fracture union; all the others achieved union at an average of 12 weeks. The results were excellent in terms of pain relief, movement and function; there were no infections or nonunions. The locking screws backed out or broke in 26% but this did not prejudice the outcome. Use of the Zickel system is recommended for this group of frail patients.
我们报告了33例采用齐克尔髁上钉治疗的老年或体弱患者的股骨髁上骨折。大多数患者为女性，平均年龄为79岁。所有患者都有并发疾病，只有9人能够独立行走。手术时间平均为1小时，平均失血量为100毫升。术后通过石膏支具或石膏固定进行活动。6例患者在骨折愈合前死亡；其他所有患者平均在12周时实现了骨折愈合。在疼痛缓解、活动和功能方面结果极佳；没有感染或骨不连的情况。锁定螺钉有26%出现松动或断裂，但这并未影响治疗结果。对于这类体弱患者，建议使用齐克尔系统。
