EFFECTIVENESS OF ANTERIOR KNEE INCISION BY PATELLAR LONGITUDINAL APPROACH FOR OSTEOTOMY IN TREATMENT OF DISTAL FEMORAL TYPE C FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JINJingri , RENHongge , LIUYanqun , JINRi ,  LILin

Department of Orthopedics, Yanbian University Affiliated Hospital, Yanji Jilin, 133000, P. R. China;

Corresponding author：

LILin, Email: lilin0571@163.com

Keywords：

Distal femoral fracture; Anterior knee incision; Patellar approach

DOI：

10.7507/1002-1892.20150151

Video：

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Objective To investigate the effectiveness of anterior knee incision by the patellar longitudinal approach for osteotomy in treating type C fractures of the distal femur. Methods Between March 2010 and June 2014, 36 patients with type C fractures of the distal femur underwent fracture reduction and internal fixation by patellar longitudinal approach for osteotomy. There were 25 males and 11 females, aged 26-72 years (mean, 49 years). Injury causes included traffic accident injury (19 cases), falling injury from height (8 cases), and crushing injury (9 cases). There were 34 cases of closed fracture and 2 cases of open fracture. Associated fractures included 2 cases of patellar fracture and 4 cases of clavicular fracture; combined injuries included 4 cases of anterior cruciate ligament injury, 1 case of posterior cruciate ligament injury, 12 cases of meniscus injury, and 9 cases of medial and lateral collateral ligament injuries. It was 3-11 days from injury to operation (mean, 6 days). Results Among 36 patients, 29 were followed up 12-24 months (mean, 18 months). Primary healing of incision was obtained, without infection or lower limb deep venous thrombosis. X-ray films showed fracture healing at 12-32 weeks (mean, 16.4 weeks). Neither loosening of screw and plate breakage nor valgus and varus knee occurred. Pain and stiff of the knee joint were observed in 4 and 2 cases, respectively; 4 cases walked with a cane. According to Hospital for Special Surgery (HSS) scoring system, the results were excellent in 21 cases, good in 7 cases, and fair in 1 case; and the excellent and good rate was 96.55%. The internal fixation was removed at 10-14 months after operation, and there was no re-fracture. Conclusion The patellar longitudinal approach has the advantages of sufficient exposure, easy reduction, short operation time, good internal fixation, less damage of soft tissue, and less complication. So it is the appropriate approach to treat type C fractures of the distal femur.

Citation： JINJingri, RENHongge, LIUYanqun, JINRi, LILin. EFFECTIVENESS OF ANTERIOR KNEE INCISION BY PATELLAR LONGITUDINAL APPROACH FOR OSTEOTOMY IN TREATMENT OF DISTAL FEMORAL TYPE C FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 700-703. doi: 10.7507/1002-1892.20150151 Copy

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10.	姚永成, 王友华, 张正洲, 等. 内外侧双钢板内固定治疗复杂股骨髁间骨折. 中国骨与关节损伤杂志, 2010, 25 (1):51-52.
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1. Marsh JL, Theddy FF, Julie A, et al. Fracture and dislocation classification compendium-2007:Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma, 2007, 21(10 Suppl):S₃1-S₄2.
2. 李卫康, 戚浩天, 赵永杰, 等. 影响股骨髁间骨折术后膝关节功能的相关因素分析. 中国矫形外科杂志, 2013, 24(21):2443-2448.
3. 高兴华, 侯之启, 覃健. 不同手术入路治疗股骨远端骨折术后膝关节功能评价. 临床骨科杂志, 2007, 10(5):432-434.
4. 聂涛, 戴闽, 李明军, 等. 股骨远端C型骨折手术入路的探讨. 中国矫形外科杂志, 2010, 18(18):1580-1581.
5. Insall JN, Ranawat CS, Aglietti P, et al. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg (Am), 1976, 58(6):754-765.
6. 骆松, 戴闽, 丁志辉, 等. 新型股骨远端前外侧入路治疗股骨远端C型骨折疗效分析. 中国修复重建外科杂志, 2014, 28(4):414-418.
7. 包国玉, 郝廷, 王兴国. 双钢板内固定治疗股骨髁间C型骨折的临床疗效分析. 中国医药导报, 2011, 8(24):39-41.
8. Schandelmaier P, Partenheimer A, Koenemann B, et al. Distal femoral fractures and LISS stabilization. Injury, 2001, 32(3):55-63.
9. 韩健, 殷振华, 陈轲, 等. 股骨髁部粉碎骨折的治疗研究进展. 骨科, 2011, 2(2):107-110.
10. 姚永成, 王友华, 张正洲, 等. 内外侧双钢板内固定治疗复杂股骨髁间骨折. 中国骨与关节损伤杂志, 2010, 25 (1):51-52.
11. 吕厚山, 张洪, 主译. 膝关节外科学. 北京:人民卫生出版社, 2006:1176.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ANTERIOR KNEE INCISION BY PATELLAR LONGITUDINAL APPROACH FOR OSTEOTOMY IN TREATMENT OF DISTAL FEMORAL TYPE C FRACTURES

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