To Study Surgical Management of Distal Femoral Fractures & its Complication

R. Shrivastava, Namita Shrivastava
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Abstract

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures with its complication. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Centre, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1C1, 4-C2 and 3-C3 fractures. Complication in form of varus angulations was found in 5 cases, shortening occurred in 2 patients, backing out of distal femoral locking screw occurred in 1 patient. Deep infection occurred in 1 patient. Implant failure and varus angulations at fracture site occurred in 1 patient. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced.
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探讨股骨远端骨折的外科治疗及其并发症
背景:股骨远端骨折是一种复杂的损伤,治疗难度大。这些骨折通常是不稳定和粉碎的。尽管手术技术的进步和植入物的改进,股骨远端骨折的治疗在许多情况下仍然是一个挑战。本研究旨在分析股骨远端骨折及其并发症的功能结局和处理方法。材料与方法:本研究于2008年8月至2010年3月在印度比莱贾瓦哈拉尔尼赫鲁医院和研究中心骨科就诊的患者中进行。这是一项前瞻性研究,纳入25例符合纳入和排除标准的股骨远端a型骨折10例,B型骨折7例,C型骨折8例。结果:患者平均年龄47.08岁,性别发病率为3.17:1(男:女)。损伤方式为RTA 16例,单纯坠落6例,高空坠落2例,轨道事故1例。骨折类型有5-A1、1-A2、4-A3、3-B1、1-B2、3-B3、1C1、4-C2和3-C3。并发症为内翻成角5例,短缩2例,股骨远端锁定螺钉退出1例。1例发生深部感染。1例患者发生骨折部位内翻和假体失败。结论:我们认为微创手术技术和锁定型钢板的可用性可以处理股骨远端骨折更多的进动,并且可以产生更满意的结果。
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