复杂股骨远端骨折的治疗

Abstract

Abstract: Complex distal femoral fractures refer to those comminuted fractures which distal femoral metaphysis and femoral condyles are involved.Since mostly caused by high-energy injury,the management of complex distal femoral fractures remains difficult and the prognosis is poor.In recent years,a lot of experimental and clinical studies have been taken in and abroad to investigate the progress of reduction techniques,surgical methods,fixation materials and many other aspects in managing complex distal femoral fractures and some achievements have been reached.Reduction techniques can be divided into direct and indirect reduction,and surgical Methods along with fixation techniques include traditional ORIF,minimally invasive operating techniques,intramedullary nails,screw-plate system and prosthetic replacement.In this article,a review will be made around those aspects above to provide a guideline of the clinical management of complex distal femoral fractures.

Key words: Distal femur, Complex fractures, Internal fixation, Therapy

CLC Number:

R 683.42

JIANG Bo,YUAN Feng. Management of complex distal femoral fractures[J]. Surgical Research and New Technique, 2014, 3(1): 69-73.

References

[1] Winquist RA,Hansen STJr ,Clawson DK.Closed intramedullary nailing of femoral fractures.A report of five hundred and twenty cases.1984[J].J Bone Joint Surg Am,2001,83(12):1912.
[2] 张世民,李海丰,黄轶刚.骨折分类与功能评定[M].北京:人民军医出版社,2008:49-51.
[3] 刘璠,蔡玉辉,赵剑,等.股骨远端复杂骨折的手术治疗[J].江苏医药,2006,32(1):20-22.
[4] Thomas TL,Meggitt BF.A comparative study of methods for treating fractures of the distal half of the femur[J].J Bone Joint Surg Br,1981,63(1):3-6.
[5] Butt MS,Krikler SJ,Ali MS.Displaced fractures of the distal femur in elderly patients.Operative versus non-operative treatment[J].J Bone Joint Surg Br,1996,78(1):110-114.
[6] Moss DP,Tejwani NC.Biomechanics of external fixation:a review of the literature[J].Bull NYU Hosp Jt Dis,2007,65(4):294-299.
[7] Ramesh LJ,Rajkumar SA,Rajendra R,et al.Ilizarov ring fixation and fibular strut grafting for C3 distal femoral fractures[J].J Orthop Surg (Hong Kong),2004,12(1):91-95.
[8] Arazi M,Memik R,Ogun TC,et al.Ilizarov external fixation for severely comminuted supracondylar and intercondylar fractures of the distal femur[J].J Bone Joint Surg Br,2001,83(5):663-667.
[9] 任高宏,沈开金.股骨远端骨折的治疗现状与进展[J].中国矫形外科杂志,2003,11(3):246.
[10] Stoffel K,Lorenz KU,Kuster MS.Biomechanical considerations in plate osteosynthesis:the effect of plate-to-bone compression with and without angular screw stability[J].J Orthop Trauma,2007,21(6):362-368.
[11] Krettek C,Müller M,Miclau T.Evolution of minimally invasive plate osteosynthesis (MIPO) in the femur[J].Injury,2001,32(Suppl 3):SC14-23.
[12] Farouk O,Krettek C,Miclau T, et al.Effects of percutaneous and conventional plating techniques on the blood supply to the femur[J].Arch Orthop Trauma Surg,1998,117(8):438-41.
[13] 关继奎,关雨,赵丽,等.内固定物置入治疗股骨远端骨折的生物力学变化与临床效果[J].中国组织工程研究,2013,17(13):2439-2446.
[14] Schütz M,Müller M,Krettek C, et al.Minimally invasive fracture stabilization of distal femoral fractures with the LISS:a prospective multicenter study.Results of a clinical study with special emphasis on difficult cases[J].Injury,2001,32(Suppl 3):SC48-54.
[15] 林昂如,高道海,胡罢生.内固定物置股骨远端粉碎性骨折双板固定的生物力学研究[J].第一军医大学学报,2002,22(2):148-150.
[16] Sanders R,Swiontkowski M,Rosen H,et al.Double plating of comminuted,unstable fractures of the distal part of the femur[J].J Bone Joint Surg Am,1991,73(3):341-346.
[17] Janzing HM,Stockman B,Van Damme G,et al.The retrograde intramedullary supracondylar nail:an alternative in the treatment of distal femoral fractures in the elderly[J].Arch Orthop Trauma Surg,1998,118(1-2):92-95.
[18] 李保良,魏思奇,王建民,等.股骨远端逆行交锁钉加骨栓治疗股骨髁粉碎性骨折[J].第一军医大学学报,2004,24(12):1448-1449.
[19] Kulkarni SG,Varshneya A,Kulkarni GS,et al.Antegrade interlocking nailing for distal femoral fractures[J].J Orthop Surg (Hong Kong),2012,20(1):48-54.
[20] Seyhan M,Cakmak S,Donmez F,et al.Blocking screws for the treatment of distal femur fractures[J].Orthopedics,2013,36(7):e936-941.
[21] Kumar A,Jasani V,Butt MS.Management of distal femoral fractures in elderly patients using retrograde titanium supracondylar nails[J].Injury,2000,31(3):169-173.
[22] Meyer RW,Plaxton NA,Postak PD,et al.Mechanical comparison of a distal femoral side plate and a retrograde intramedullary nail[J].J Orthop Trauma,2000,14(6):393-404.
[23] Whnert D,Hoffmeier KL,von Oldenburg G,et al.Internal fixation of type-C distal femoral fractures in osteoporotic bone[J].J Bone Joint Surg Am,2010,92(6):1442-1452.
[24] Pekmezci M,McDonald E,Buckly J,et al.Retrograde intramedullary nails with distal screws locked to the nail have higher fatigue strength than locking plates in the treatment of supracondylar femoral fractures:A cadaver-based laboratory investigation[J].Bone Joint J,2014,96(1):114-121.
[25] Henry SL.Supracondylar femur fractures treated percutaneously[J].Clin Orthop Relat Res,2000,Jun,(375):51-59.
[26] Cies′lik P,Piekarczyk P,Marczyński W.Results of retrograde intramedullary nailing for distal femoral fractures-own experience[J].Ortop Traumatol Rehabil,2007,9(6):612-617.
[27] Salem KH,Maier D,Keppler P,et al.Limb malalignment and functional outcome after antegrade versus retrograde intrameduulary nailing in distal femoral fractures[J].J Trauma,2006,61(2):375-381.
[28] Hartin NL,Harris I,Hazratwala K.Retrograde nailing versus fixed-angle blade plating for supra-condylar femoral fractures:a randomized controlled trial[J].ANZ J Surg,2006,76(5):290-294.
[29] Berend KR,Lombardi AV Jr.Distal femoral replacement in nontumor cases with severe bone loss and instability[J].Clin Orthop Relat Res,2009,467(2):485-492.
[30] 林昂如,任高宏,胡罢生,等.聚乙烯、钛合金板固定治疗股骨远端粉碎性骨折[J].中国骨伤,2002,15(8):479-480.
[31] Pemberton DJ,Evans PD,Grant A,et al.Fractures of the distal femur in the elderly treated with a carbon fibre supracondylar plate[J].Injury,1994,25(5):317-321.

Management of complex distal femoral fractures

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