2017, Number 1
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Acta Ortop Mex 2017; 31 (1)
Articular fractures of the distal femur. Comparative analysis of three surgical treatments
Souki-Chmeit F, Zambrano-Sanguinetti E, Sandia-Briceño A, Souki-Chmeit A, Brito-Velásquez M
Language: Spanish
References: 24
Page: 1-11
PDF size: 942.93 Kb.
ABSTRACT
Introduction: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment.
Objectives: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA).
Material and methods: We conducted a comparative study of three therapeutic series designed to compare the effectiveness of dynamic condylar screw, the condylar buttress plate and periarticular plate in treating complete articular fractures of distal femur type C2. Patients of both genders, aged between 16 and 60 years, treated in the IAHULA, with a minimum follow up of 24 months.
Results: We included 42 patients divided into three groups. Males predominated with 73.8%, the most affected age group was 21-30 years with 28.57%. The most common type of fracture was the 33C2.3 with 42.86%. The 71.43% of patients experienced complications, highlighting joint stiffness, angular deviation in recurvatum, chronic pain and post traumatic osteoarthritis.
Conclusion: TDC and the PPA are valid options for the treatment of distal femur fractures AO 33C2, as offered better functional results than PSC.
REFERENCES
Schatzker J, Tile M: Supracondylar fractures of the femur (33-A, B and C). In: Schatzker J, Tile M (eds): The rationale of operative fracture care. 3rd ed. Berlín: Springer; 2005: 409-39.
Schatzker J, Mahomed N, Schiffman K, Kellam J: Dynamic condilar screw: a new device. J Orthop Trauma. 1989; 3: 124-32.
Rüedi T, Buckley R, Moran C: AO Principles of fracture management. 2nd ed. New York: Thieme; 2007.
Beaty J: Orthopaedic Knowledge Update. American Academy of Orthopaedic Surgeons. 2001.
Forster MC, Komarsamy B, Davison JN: Distal femoral fractures: a review of fixation methods. Injury. 2006; 37: 97-108.
Stewart MJ, Sisk TD, Wallace SL: Fractures of the distal end of the femur. JBJS. 1966; 48A: 784-807.
Valles-Figueroa JFJ, Rodríguez-Reséndiz F, Gómez-Mont JG: Fracturas de fémur distal. Análisis comparativo de dos diferentes tratamientos quirúrgicos. Acta Ortop Mex. 2010; 24(5): 324-30.
Wenzl H, Casey PA, Herbert P, Belin J: Die operative Behandling der distalen Femurfraktur. AO Bull; 1970.
Bucholz R, Heckman J: Rockwood’s & Green’s Fracturas en el adulto. 5a edición. Madrid: Marbán; 2007.
Zehntner MK, Marchesi DG, Burch H, Ganz R: Alignment of supracondylar/intercondylar fractures of the femur after internal fixation by AO/ASIF technique. J Orthop Trauma. 1992; 6: 3-26.
Babst R, Bavonratanavech S, Pesantez R: Minimally invasive plate osteosynthesis (MIPO). Thieme AO Publishing. Second expanded edition. 2012.
Leuning M, Hertel R, Siebenrock KA, Balmer FT, Mast JW: The evolution of indirect reduction techniques for the treatment of fractures. Clin Orthop. 2000; 375: 7-14.
Kolb W, Guhtman H, Windisch C, Marx F, Kolb K, Koller H: Fixation of distal femoral fractures with the less invasive stabilization system: a minimally invasive treatment with locked fixed-angle screws. J Trauma. 2008; 65: 1425-34.
Nasr AM, Mcleod I, Sabboubeh A, Maffulli M: Conservative or surgical management of distal femoral fractures. A retrospective study with a minimum five year follow-up. Acta Orthop Belg. 2000; 66: 477-83.
Müller M, Koch P, Nazarian S, Schatzker J: The comprehensive classification of fractures of long bones. Berlin: Springer-Verlag; 1990.
Insall JN, Dorr LD, Scott RD, Scott WN: Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989; (248): 13-4.
Montoya A: Tratamiento de las fracturas de diáfisis tibial [Tesis de recepción de grado]. México, D.F.: IMSS-UNAM; 1977: 28-30.
Manohar G, Shibu A: Functional outcome following ORIF of supracondylar intercondylar fracture femur. Kerala Journal of Orthopaedics. 2012; 25: 1-5.
Escalante I: Experiencia de la cátedra de clínicas ortopédica y traumatológica del Hospital Universitario de Caracas en el uso de la placa de sostén condílea AO/ASIF en fracturas del extremo distal del fémur. Trabajo de ascenso AO Alumni. Caracas, 2002.
Duque D: Resultados finales en pacientes adultos tratados quirúrgicamente por fracturas del tercio distal del fémur en el IAHULA años 1992-2000: estudio tipo serie clínica. Rev Venez Cir Ortop Traumatol. 2009; 41: 15-30.
Manrique C, Lizaur A, Miralles F: Fracturas supracondíleas de fémur tratadas con clavo retrógrado versus tornillo condilar dinámico. Rev Esp Cir Osteoart. 2012; 249(47): 7-14.
Jeon IH, Oh CW, Kim SJ, Park BC, Kyung HS, Ihm JC: Minimally invasive percutaneous plating of distal femoral fractures using dynamic condylar screw. J Trauma. 2004; 57: 1048-52.
Kregor PJ, Stannard JA, Zlowodzki M, Cole PA: Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma. 2004; 18: 509-20.
Sala D, Fernández E, Gomar F, Jolin Y: Fracturas de la extremidad distal del fémur. Tratamiento quirúrgico versus tratamiento ortopédico. Rev Esp Cir Osteoart. 1997; 32: 115-9.