title: [EFFECTIVENESS OF ANTERIOR KNEE INCISION BY PATELLAR LONGITUDINAL APPROACH FOR OSTEOTOMY IN TREATMENT OF DISTAL FEMORAL TYPE C FRACTURES].
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.forename: Jingri
authors.initials: J
authors.lastname: Jin
authors.forename: Hongge
authors.initials: H
authors.lastname: Ren
authors.forename: Yanqun
authors.initials: Y
authors.lastname: Liu
authors.forename: Ri
authors.initials: R
authors.lastname: Jin
authors.forename: Lin
authors.initials: L
authors.lastname: Li
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone; D005597:Fractures, Open; D006801:Humans; D007718:Knee Injuries; D007719:Knee Joint; D008297:Male; D010027:Osteotomy; D010329:Patella; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D017695:Soft Tissue Injuries; D016896:Treatment Outcome