[Surgical treatment of distal femoral fractures using extra-medullary osteosynthesis].
Forty seven fractures of the distal femur treated by internal fixation using a supracondylar compression screw or blade plate were retrospectively evaluated regarding their radiological and functional results. Blade plates were used for all types of distal femoral fractures until 1992; their indications were subsequently restricted to simple supracondylar fractures whereas a compression screw was preferred for other types of fractures. Taking into account the condition of the patients before fracture, 85% good and very good results were achieved with both techniques. Malunions resulted in poor functional outcomes (50% good and very good results). Malunions were mainly observed in patients with complex fractures (90% of cases with malunion), which confirms the poor prognosis of comminuted fractures. Nonunions (65%) and infection (3%) resulted in poor functional results. The presence of a bony defect in the medial femoral cortex increases the risk of nonunion; bone grafting should be used in such cases. The recent use of a long femoro-femoral external distractor in a few patients has proved of value as it allowed to achieve accurate reduction and considerably eased fracture reduction and fixation.
Département de Chirurgie Orthopédique et Traumatologique, Hôpital de Braine-l'Alleud-Waterloo, Belgique.
G
G
Lamraski
D
D
Toussaint
J
J
Bremen
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects / Q000592:standards*; D001863:Bone Screws / Q000009:adverse effects / Q000592:standards*; D016025:Bone Transplantation; D005260:Female; D005264:Femoral Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome