Surgical repair of juxta-articular distal femur fractures and posttraumatic conditions

Kauts O.A., Barabash A.P., Barabash Y.A., Grazhdanov K.A., Rusanov A.G.

Abstract


Objective
To retrospectively review surgical repair of juxta-articular distal femur fractures and posttraumatic conditions.
Material and methods
The review included 65 patients with juxta-articular distal femur fractures and posttraumatic conditions repaired with plating (n = 44), intramedullary nailing (n = 16) and transosseous osteosynthesis (n = 5) between 2009 and 2016. The patients were divided into 2 groups depending on time of injury. SOI-1 was used for outcome measure.
Results
Functional recovery was observed in 71 to 97 % (average, 89.1 ± 0.6 %) of the first group at short-term followup and an average of 94.7 ± 0.45 % of anatomical and function norm at a long term. Short-term anatomical and functional outcomes ranged from 63 to 93 scores in the second group and were an average of 82 ± 0.7 % of the norm.
Conclusion
Better outcomes were obtained in the first group (an average of 94.7 ± 0.45 % of anatomical and functional norm). Plating with accurate bone reduction and reliable fixation provided throughout consolidation phase showed better outcomes in both groups of patients. Intramedullary nailing was practical for straightforward supracondylar injuries type 33А1. Transosseous osteosynthesis could be advocated for open and gunshot injuries to minimize risk of infection and provide stable bone fixation.

Keywords


distal femur, fracture, plating, intramedullary nail, transosseous osteosynthesis, DCS, LCP plate

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