Moran M C, Brick G W, Sledge C B, Dysart S H, Chien E P
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Clin Orthop Relat Res. 1996 Mar(324):196-209. doi: 10.1097/00003086-199603000-00023.
Twenty-nine supracondylar femoral fractures above total knee arthroplasty were studied retrospectively. Group 1 consisted of 5 nondisplaced fractures managed with closed treatment, yielding 5 satisfactory results. Group 2 consisted of 9 displaced fractures managed with closed treatment. There were no satisfactory results in Group 2; there were 8 malunions and 2 knees requiring revision. Group 3 consisted of 15 displaced fractures managed with open reduction and internal fixation. There were 10 satisfactory results in Group 3; there were 2 malunions and 3 knees requiring revision or repeat fixation. On the basis of these results, closed treatment for nondisplaced fractures is recommended. If displacement exists, early open reduction and internal fixation yields the greatest chance for a satisfactory result, though it has a significant complication rate.
对29例全膝关节置换术后股骨髁上骨折进行回顾性研究。第1组包括5例无移位骨折，采用闭合治疗，获得5例满意结果。第2组包括9例移位骨折，采用闭合治疗。第2组无满意结果；有8例畸形愈合，2例膝关节需要翻修。第3组包括15例移位骨折，采用切开复位内固定治疗。第3组有10例满意结果；有2例畸形愈合，3例膝关节需要翻修或再次固定。基于这些结果，建议对无移位骨折采用闭合治疗。如果存在移位，早期切开复位内固定获得满意结果的机会最大，尽管其并发症发生率较高。
