Treatment of supracondylar femoral fractures using arthroscopically assisted percutaneous retrograde interlocking nailing / 中华骨科杂志

ABSTRACT

Objective To discuss the clinical technique and outcomes of the treatment with arthroscopically assisted percutaneous retrograde interlocking nailing for supracondylar femoral fractures. Methods From July 2001 to June 2003, there were 22 supracondylar femoral fractures which were 19 fresh fractures and 3 old fractures. There were 10 males and 12 females, and the average age of which was 39.5 years ranging from 22 to 65 years. 7 patients sustained falls, and the other 15 patients were caused by traffic accidents. According to the AO/ASIF classification system, 7 fractures were evaluated as type A1, 8 type A2 and 7 type A3. All the patients were treated by arthroscopically assisted percutaneous retrograde interlocking nailing. Some additional lesions were also treated under arthroscopy simultaneously, including 3 releases for the stiff knee, 2 removals of the loose bodies, 7 debridements and lavages for the osteoarthritis, and 3 bone grafts for the fracture union. Results The average operative time was 130 minutes ranging from 90 to 210 minutes, and the average blood loss was 100 ml. The reduction and fixation were proved to be satisfactory by the postoperative roentgenogram. 20 patients were available for follow-up, which ranged from 6 to 24 months with an average of 14 months. All the fractures were united on an average of 3.3 months postoperatively except one ranging from 2 to 6 months. The one with fracture union were reoperated with bone grafting and compressive plate fixation, and the fracture healed 3 months later. The range of motion was beyond 90? in all patients, no breakage of internal fixation instruments or wound infection occurred. The functional results of knee joint were assessed as excellent in 14, good in 5 and fair in 1, and the rate of excellent and good was 95%. Conclusion The percutaneous retrograde interlocking nailing for the supracondylar femoral fractures is proved to have many advantages, such as less trauma and blood loss, and accurate location, which are beneficial to both of the fracture union and functional recovery.