Surgical outcomes of simple distal femur fractures in elderly patients treated with the minimally invasive plate osteosynthesis technique: can percutaneous cerclage wiring reduce the fracture healing time?
| Autor: | Kyeu-Back Kwon, Ji Wan Kim, Jae-Ho Lee, Ki-Chul Park, Seung-Jae Lim |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Percutaneous Radiography medicine.medical_treatment Nonunion Bone healing 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Femur Reduction (orthopedic surgery) Retrospective Studies Fracture Healing 030222 orthopedics business.industry 030229 sport sciences General Medicine medicine.disease Sagittal plane Surgery medicine.anatomical_structure Treatment Outcome Coronal plane Orthopedic surgery business Bone Plates Femoral Fractures Bone Wires |
| Zdroj: | Archives of orthopaedic and trauma surgery. 140(10) |
| ISSN: | 1434-3916 |
| Popis: | Achieving adequate reduction is difficult when performing minimally invasive plate osteosynthesis (MIPO) in elderly patients with simple distal femur fracture. This study aimed to evaluate the elderly patients who had undergone percutaneous wiring-assisted reduction with MIPO for simple distal femur fractures to determine the effect of this technique on reduction quality and fracture union. Between January 2009 and September 2017, 56 patients (56 femurs) with displaced simple distal femur fractures treated with MIPO at three trauma centers were finally enrolled. The MIPO technique with percutaneous cerclage wire reduction was performed in 25 patients (Group A). Among them, 12 patients had a simple spiral metaphyseal fracture (Group A*). In comparison, MIPO without percutaneous cerclage wire reduction was performed in 31 patients (Group B). Among them, seven patients had a simple spiral metaphyseal fracture (Group B*). Medical records containing surgical records were retrospectively reviewed to investigate demographic data, comorbidities, complications, operative time, and fluoroscopic time. Radiographs were evaluated for assessing the quality of the reduction and fracture union. The mean fracture union time of Group A* was 21.7 weeks, which was significantly shorter than that of Group B* (28.6 weeks). The mean coronal and sagittal angulation in Group A* was 0.6° and 0.7°, respectively, which were significantly lesser than those in Group B* (2.4° and 3.2°, respectively). Mean translation in Group A* was 1.43 mm, which was significantly shorter than that in Group B* (3.81 mm). Nonunion occurred in two patients in Group B. Surgical treatment of simple spiral distal femur fractures with percutaneous cerclage wiring-assisted reduction and the MIPO technique in elderly patients resulted in better reduction and faster union time. Therefore, this technique could be a good solution if used in accordance with the indication. |
| Databáze: | OpenAIRE |
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