Treatment effect of the coronal fractures of the femoral condyle with open reduction and internal fixation / 中国矫形外科杂志

ABSTRACT

[Objective] To discuss the method and clinical effects of coronal fractures of the femoral condyle treated with open reduction plus cancellous lag screw internal fixation.[Method]From May 1998 to June 2006,17 cases of coronal fractures of femoral condyle were treated with open reduction 'and cancellous lag screw internal fixation by using anterolateral for typ Ⅰ or typ Ⅲ lateral femoral condylar fracture(LFCF)/anteromedial for type Ⅰ or type Ⅲ medial femoral condylar fracture(MFCF)or posterolateral for type ⅡLFCF/posteromedial approach for type Ⅱ MFCF.There were 15 males and 2 females with the average age 39.5 years,ranging from 19 to 48 years.According to Letenneur classification,there were type Ⅰfracture 7 cases,type Ⅱ 4 cases,and type Ⅲ 6 cases.Among them,14 cases were closed fracture,3 eases were open fracture.Auto ilium transplant or homologous allograft bone transplant(5 cases)were also used.All patients were treated with plaster external fixation after operation.The interval between injury and surgery averaged 3.6 days(2.5 hours to 8 days).[Result]All patients were followed up for 8～26 months with an average of 18.2 months.All fractures got bone union with average union time 3.6 months.Knee joint function was rated based on Letenneur evaluation system and showed excellen and good in 14 cases,fine in 3 cases and no poor.There were no deep infection,implant failure or bone necrosis.[Conclusion]Open reduction plus cancellous lag screw internal fixation is an ideally safe and effective operation to treat coronal fractures of the femoral condyle.Accurate choice of approach,satisfactory reduction and rigid internal fixation have important influence on clinical outcomes.