Osteotomy and secondary fixation to treat malunion after the distal femoral fracture / 中华创伤骨科杂志

ABSTRACT

Objective To introduce a two-stage operative method to treat ma lu nion after the distal femoral fracture. Methods From Aug. 1992 to Aug. 2000, 12 patients underwent osteotomy and secondary fixation due to malunion after the di stal femoral fracture. There were 10 closed fractures and 2 open ones. The prima ry treatment was conservative for 2 patients, and operative for 10. We first per formed the osteotomy along the primary fracture line where the deformity was the most severe. When the roentgenogram confirmed that the deformity had been corre cted satisfactorily, a secondary operation of ORIF (open reduction with internal fixation) was performed. Results On average, all the 12 patients gained bone un ion 5.1 months postoperatively. The mean follow-up duration was 7.2 years (rang e 3.5 to 11.5 years). None of the patients was afflicted by infection or loosen ing of the internal fixator. According to the Schatzker scoring scale system, al l the patients were evaluated as poor preoperatively, but as excellent in 7, goo d in 4 and fair in 1 at the last follow-up. Conclusion Osteotomy and secondary fixation is not only simple and accessible but also can lead to confirmed clinic al results. However, it is still very important to reduce and fix the acute frac tures stably to avoid malunion.