The use of interfragmentary positional screw in minimally invasive plate osteosynthesis for simple distal femur fractures in elderly patients: A retrospective,single-centre pilot study |
| |
| Affiliation: | 1. Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, South Korea;2. Department of Mathematics, College of Natural Science, Ajou University, Gyeonggi, South Korea;1. Laboratory of Human Anatomy, Thomson Building, School of Life Sciences, College of Medical, Veterinary and Life Sciences, Univeristy of Glasgow, UK;2. Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, UK;1. Division of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland;2. Center for Surgery of the Foot & Ankle, Clinique La Colline, Geneva, Switzerland;3. Division of Anatomy, University of Geneva Medical Center, Geneva, Switzerland;4. Faculté de Médecine, University of Geneva Medical Center, Geneva, Switzerland;1. Department of Surgery, University of Calgary, Calgary, Alberta, Canada;2. Department of Surgery, University of California, San Francisco, CA, United States;1. Center for Orthopaedic and Trauma Surgery, University Hospital Gießen and Marburg, Location Marburg, Baldingerstr., 35043 Marburg, Germany;2. Institute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Cologne, Germany;3. Committee on Emergency Medicine, Intensive Care and Trauma Management of the German Trauma Society (Sektion NIS), Germany;1. R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, United States;2. R Adams Cowley Shock Trauma Center, Division of Infectious Disease, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States;3. Laboratories of Pathology, University of Maryland Medical System, Baltimore, MD, United States |
| |
| Abstract: | IntroductionMinimally invasive plate osteosynthesis (MIPO) using locking plates has been used in distal femur fractures, but various problems, such as nonunion, malalignment, and implant failure, have been reported. Simple fractures sometimes have poorer outcomes than complex fractures. We studied elderly patients with simple fracture patterns who underwent open reduction followed by placement of a single positional screw to hold the reduced interfragmentary gap, and compared these cases with patients who underwent surgery using conventional MIPO techniques.Patients and methodsA retrospective analysis was conducted on 80 cases of patients with distal femur fractures and simple fracture patterns (33-A1, A2, and C1). The mean age was 74 (60–90) years, and the mean follow-up period was 14 (12–25) months. Group A included 40 patients who underwent conventional MIPO technique while Group B included 40 patients who had surgery using positional screws. Interfragmentary gaps in Group B were reduced using percutaneous reduction clamps, and cortical screws were inserted to sustain the reduction. Then, locking plates were inserted using conventional MIPO techniques.ResultsBony union was achieved in all 80 cases, mean initial callus formation was observed in 11 weeks (8–13 weeks), and radiological union was observed in 27 weeks (15–54 weeks). Time to initial callus formation was not different, but radiologic union was achieved in 30 weeks (18–54 weeks) for Group A and 25 weeks (15–41 weeks) for Group B (p = 0.006). No differences were seen in clinical function at 1 year (p = 0.580). Five cases of malalignment occurred in Group A (p = 0.021). The rate of union during the 1-year period was significantly higher in group B than in group A (p = 0.002).ConclusionsIn a distal femur fracture with a simple fracture pattern, using positional screws to sustain the reduced interfragmentary gap may achieve a more rapid union by reducing fracture gap. Though functional differences were not seen in follow-ups, patients can be expected to return to their normal lives earlier as union is achieved in a shorter time. Performing MIPO using positional screws to sustain the reduced interfragmentary gap after fracture reduction will be helpful in the treatment of simple femoral fracture. |
| |
| Keywords: | Distal femoral fracture MIPO Positional screw Simple fracture Osteoporosis |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
