Postoperative early rehabilitation training for supracondylar fracture of femur aids in accelerating the healing of fractures with shorter recovery periods. Presently, clinical studies on post-operative early weight t...Postoperative early rehabilitation training for supracondylar fracture of femur aids in accelerating the healing of fractures with shorter recovery periods. Presently, clinical studies on post-operative early weight training are still in the nascent stages. The weight bearing capacity at different healing stages typically depends on clinical experience and there is a lack of standards to quantify the weight that would be conducive to the healing of fractures. In this paper, a 3D geometric model of the femur is obtained using imaging data, a locking plate fixation model of a simple supracondylar fracture of the femur, which considers the angle and spatial direction of the fracture surface, is established, the stress distribution and load transmission mechanism of the fracture fixation model on a single leg standing posture are studied and the weight bearing capacity of a standing single leg at the early stage of fracture is given. This provides the basis for objective quantification of postoperative early weight bearing capacity.展开更多
Objective： To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods： According to the AO classification, all of 32 cases were classifi...Objective： To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods： According to the AO classification, all of 32 cases were classified as extra-articular type A. 32 cases were treated with interlocking intramedullary nail by closed insertion from intercondylar fossa of the knee. All cases accepted CPM exercise as early as possible after operation. Results： Following up 5 to 15 months, all fractures united within an average duration of 5.3 months （4-7 months）. According to the Shelbourne scale, the excellent rate of the knee function was 86.3%. Conclusion： Retrograde interlocking intramedullary nail is useful alternative implant for the treatment of osteoporotic supracondylar fracture of femur, particularly of the type A fracture in the elderly population. Its merits include stable fixation, high rate of fracture union and few complications.展开更多
Purpose:Distal femoral fracture is one of the most common lower limb injuries and accounts for less than 1%of all fractures.Open fracture takes 5%-10%of the all distal femoral fractures,which is at an increased risk o...Purpose:Distal femoral fracture is one of the most common lower limb injuries and accounts for less than 1%of all fractures.Open fracture takes 5%-10%of the all distal femoral fractures,which is at an increased risk of complications.There were limited studies which documented the outcomes of such cases.The present study aims to evaluate the outcome and complications in these fractures using primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement.Methods:This is a prospective study conducted in a tertiary care orthopaedic hospital in northern India.Thirty patients of open distal femoral fractures were managed by primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement.They were followed for minimum of six months.Patients were followed up monthly for first four months,at six months and one year after surgery.Clinical and radiological signs of healing,any complications,time to union,and functional outcome were assessed.Results:The mean age of patients was 44.33 years(range 20-82 years)with male predominance of 66.7%.According to Gustilo-Anderson classification,there were 5,15 and 10 patients with open grade I,II and IIIA distal femoral fractures respectively.According to orthopaedic trauma association(OTA)classification,majority of patients in our study were of C3 type.The mean time to bony union was 5.6 months(range 4-9 months).Average postoperative knee range of motion(ROM)at the latest follow-up was 98°(range 70°-120°).Lysholm knee scoring scale showed excellent score in 11 patients,good in 9 patients,fair and poor in 5 patients each;however,there was no significant correlation with fracture pattern types(p<0.05).Knee stiffness was the major complications encountered in the study.The knee ROM was<90°in 5 patients and 90°-120°in rest of the patients,while 1 patient had extensor lag of 10°.One patient had implant failure and lost to follow-up;3 patients had deep infection.Conclusion:An approach of primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to early aggressive debridement in open distal femur fractures shows significant results in terms of functional and radiological outcomes with minimal complications.展开更多
基金The work was supported by the National Natural Science Foundation of China (Grants 11672297, 11872273, and 11472191)the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant XDB22020200)the Opening Fund of the State Key Laboratory of Nonlinear Mechanics.
文摘Postoperative early rehabilitation training for supracondylar fracture of femur aids in accelerating the healing of fractures with shorter recovery periods. Presently, clinical studies on post-operative early weight training are still in the nascent stages. The weight bearing capacity at different healing stages typically depends on clinical experience and there is a lack of standards to quantify the weight that would be conducive to the healing of fractures. In this paper, a 3D geometric model of the femur is obtained using imaging data, a locking plate fixation model of a simple supracondylar fracture of the femur, which considers the angle and spatial direction of the fracture surface, is established, the stress distribution and load transmission mechanism of the fracture fixation model on a single leg standing posture are studied and the weight bearing capacity of a standing single leg at the early stage of fracture is given. This provides the basis for objective quantification of postoperative early weight bearing capacity.
文摘Objective： To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods： According to the AO classification, all of 32 cases were classified as extra-articular type A. 32 cases were treated with interlocking intramedullary nail by closed insertion from intercondylar fossa of the knee. All cases accepted CPM exercise as early as possible after operation. Results： Following up 5 to 15 months, all fractures united within an average duration of 5.3 months （4-7 months）. According to the Shelbourne scale, the excellent rate of the knee function was 86.3%. Conclusion： Retrograde interlocking intramedullary nail is useful alternative implant for the treatment of osteoporotic supracondylar fracture of femur, particularly of the type A fracture in the elderly population. Its merits include stable fixation, high rate of fracture union and few complications.
文摘Purpose:Distal femoral fracture is one of the most common lower limb injuries and accounts for less than 1%of all fractures.Open fracture takes 5%-10%of the all distal femoral fractures,which is at an increased risk of complications.There were limited studies which documented the outcomes of such cases.The present study aims to evaluate the outcome and complications in these fractures using primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement.Methods:This is a prospective study conducted in a tertiary care orthopaedic hospital in northern India.Thirty patients of open distal femoral fractures were managed by primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement.They were followed for minimum of six months.Patients were followed up monthly for first four months,at six months and one year after surgery.Clinical and radiological signs of healing,any complications,time to union,and functional outcome were assessed.Results:The mean age of patients was 44.33 years(range 20-82 years)with male predominance of 66.7%.According to Gustilo-Anderson classification,there were 5,15 and 10 patients with open grade I,II and IIIA distal femoral fractures respectively.According to orthopaedic trauma association(OTA)classification,majority of patients in our study were of C3 type.The mean time to bony union was 5.6 months(range 4-9 months).Average postoperative knee range of motion(ROM)at the latest follow-up was 98°(range 70°-120°).Lysholm knee scoring scale showed excellent score in 11 patients,good in 9 patients,fair and poor in 5 patients each;however,there was no significant correlation with fracture pattern types(p<0.05).Knee stiffness was the major complications encountered in the study.The knee ROM was<90°in 5 patients and 90°-120°in rest of the patients,while 1 patient had extensor lag of 10°.One patient had implant failure and lost to follow-up;3 patients had deep infection.Conclusion:An approach of primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to early aggressive debridement in open distal femur fractures shows significant results in terms of functional and radiological outcomes with minimal complications.
