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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Abstract Full text Figures/Tables Video References Cited by

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

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.	李衛康, 戚浩天, 趙永杰, 等. 影響股骨髁間骨折術后膝關節功能的相關因素分析. 中國矯形外科雜志, 2013, 24(21):2443-2448.
3.	高興華, 侯之啟, 覃健. 不同手術入路治療股骨遠端骨折術后膝關節功能評價. 臨床骨科雜志, 2007, 10(5):432-434.
4.	聶濤, 戴閩, 李明軍, 等. 股骨遠端C型骨折手術入路的探討. 中國矯形外科雜志, 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.	駱松, 戴閩, 丁志輝, 等. 新型股骨遠端前外側入路治療股骨遠端C型骨折療效分析. 中國修復重建外科雜志, 2014, 28(4):414-418.
7.	包國玉, 郝廷, 王興國. 雙鋼板內固定治療股骨髁間C型骨折的臨床療效分析. 中國醫藥導報, 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.	韓健, 殷振華, 陳軻, 等. 股骨髁部粉碎骨折的治療研究進展. 骨科, 2011, 2(2):107-110.
10.	姚永成, 王友華, 張正洲, 等. 內外側雙鋼板內固定治療復雜股骨髁間骨折. 中國骨與關節損傷雜志, 2010, 25 (1):51-52.
11.	呂厚山, 張洪, 主譯. 膝關節外科學. 北京:人民衛生出版社, 2006:1176.

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. 李衛康, 戚浩天, 趙永杰, 等. 影響股骨髁間骨折術后膝關節功能的相關因素分析. 中國矯形外科雜志, 2013, 24(21):2443-2448.
3. 高興華, 侯之啟, 覃健. 不同手術入路治療股骨遠端骨折術后膝關節功能評價. 臨床骨科雜志, 2007, 10(5):432-434.
4. 聶濤, 戴閩, 李明軍, 等. 股骨遠端C型骨折手術入路的探討. 中國矯形外科雜志, 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. 駱松, 戴閩, 丁志輝, 等. 新型股骨遠端前外側入路治療股骨遠端C型骨折療效分析. 中國修復重建外科雜志, 2014, 28(4):414-418.
7. 包國玉, 郝廷, 王興國. 雙鋼板內固定治療股骨髁間C型骨折的臨床療效分析. 中國醫藥導報, 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. 韓健, 殷振華, 陳軻, 等. 股骨髁部粉碎骨折的治療研究進展. 骨科, 2011, 2(2):107-110.
10. 姚永成, 王友華, 張正洲, 等. 內外側雙鋼板內固定治療復雜股骨髁間骨折. 中國骨與關節損傷雜志, 2010, 25 (1):51-52.
11. 呂厚山, 張洪, 主譯. 膝關節外科學. 北京:人民衛生出版社, 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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