Surgical treatment of complicated distal femoral fractures / 中华创伤杂志

ABSTRACT

Objective To explore different techniques for treat me nt of complicated distal femoral fractures in order to obtain the best curative effects. Methods A retrospective study was done on the cli nical data of 62 patients (64 sides) with complicated distal femoral fractures a dmitted to our hospital from January 1999 to June 2002. According to AO classifi cation 20 cases (21 sides) belonged to type A and 42 (43 sides) to type C. The supporting steel of AO femoral condyles were applied in 18 cases (19 sides), loc ked double-plating (steel plate and polyethylene plate) in 20 (21 sides) and th e retrograde intramedullary nail in 24. All cases received scientific and ration al rehabilitative treatment post-operatively. Results The 4-38 months follow up showed that 62 cases go t fracture healing with average healing period of 4.2 months (from 10 weeks to 1 6 months). According to criteria of Kolmert and Wulff, 31 sides were excellent, 28 good but 5 poor with an excellence rate of 75%. Conclusions A majority of treatment results of complicate d distal femoral fractures are satisfactory through rational and reliable intern al fixation. The supporting steel plate is suitable for all distal femoral fract ures; and the retrograde intramedullary nail is the treatment of choice for type A and type C1 fractures. As for types C2 and C3 fractures, the locked double-p lating combined with polyethylene is more effective than the supporting steel pl ate or the retrograde intramedullary nail for it has advantages of reasonable de sign, convenient operation and firm fixation.