Xiaodong Lian1,2,3, Kuo Zhao1,2,3, Wei Chen1,2,3, Junzhe Zhang1,2,3, Junyong Li1,2,3, Hongyu Meng1,2,3, Zhiyong Hou1,2,3,4, Yingze Zhang5,6,7,8,9. 1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China. 2. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. 3. Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. 4. NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China. 5. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China. suryzz@126.com. 6. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. suryzz@126.com. 7. Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. suryzz@126.com. 8. NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China. suryzz@126.com. 9. Chinese Academy of Engineering, Beijing, 10088, P.R. China. suryzz@126.com.
Abstract
OBJECTIVE: The purpose of this prospective study was to introduce the application of a double reverse traction repositor (DRTR) in the retrograde intramedullary nailing (RE-IMN) of AO/OTA 33A distal femur fractures. PATIENTS AND METHODS: A total of 27 patients with AO/OTA type 33A distal femur fractures who were admitted from January 2015 to May 2017 to a level I trauma center of a tertiary university hospital were enrolled in this prospective study. A DRTR was used to facilitate RE-IMN for the reduction of distal femur fractures in all patients. The demographic and fracture characteristics, surgical data, postoperative complications, and prognostic indicators of 24 patients were recorded. RESULTS: The DRTR helped achieve and maintain the reduction of all distal femur fractures in the present study. All surgeries were conducted by closed reduction, and excellent alignment was observed in the postoperative X-ray images. In the present study, 18 males and 6 females were included, and the average age of all patients was 51.3 years (range, 24-68 years). The mean operation time, intraoperative blood loss, intraoperative fluoroscopy time, and length of postoperative hospital stay were 137 min (range from 80 to 210 min), 320 ml (range from 200 to 600 ml), 28 (from 24 to 33), and 9 days (from 5 to 14 days), respectively. Eleven patients were found to have postoperative deep venous thrombosis before discharge. No cases of wound infection were observed. No cases of nonunion or malunion were observed. The average follow-up duration was 21 months (18-30 months). The average HHS, LKFS, and VAS scores at the 1-year follow-up were 89.9 (86-97), 79.1 (75-87), and 2.1 (from 0 to 5). No complications associated with DRTR were found. CONCLUSIONS: A DRTR can be successfully applied in the treatment of distal femur fractures with RE-IMN, and it can not only help achieve or maintain the reduction of distal femur fractures with closed methods but also promote fixation with RE-IMN.
OBJECTIVE: The purpose of this prospective study was to introduce the application of a double reverse traction repositor (DRTR) in the retrograde intramedullary nailing (RE-IMN) of AO/OTA 33A distal femur fractures. PATIENTS AND METHODS: A total of 27 patients with AO/OTA type 33A distal femur fractures who were admitted from January 2015 to May 2017 to a level I trauma center of a tertiary university hospital were enrolled in this prospective study. A DRTR was used to facilitate RE-IMN for the reduction of distal femur fractures in all patients. The demographic and fracture characteristics, surgical data, postoperative complications, and prognostic indicators of 24 patients were recorded. RESULTS: The DRTR helped achieve and maintain the reduction of all distal femur fractures in the present study. All surgeries were conducted by closed reduction, and excellent alignment was observed in the postoperative X-ray images. In the present study, 18 males and 6 females were included, and the average age of all patients was 51.3 years (range, 24-68 years). The mean operation time, intraoperative blood loss, intraoperative fluoroscopy time, and length of postoperative hospital stay were 137 min (range from 80 to 210 min), 320 ml (range from 200 to 600 ml), 28 (from 24 to 33), and 9 days (from 5 to 14 days), respectively. Eleven patients were found to have postoperative deep venous thrombosis before discharge. No cases of wound infection were observed. No cases of nonunion or malunion were observed. The average follow-up duration was 21 months (18-30 months). The average HHS, LKFS, and VAS scores at the 1-year follow-up were 89.9 (86-97), 79.1 (75-87), and 2.1 (from 0 to 5). No complications associated with DRTR were found. CONCLUSIONS: A DRTR can be successfully applied in the treatment of distal femur fractures with RE-IMN, and it can not only help achieve or maintain the reduction of distal femur fractures with closed methods but also promote fixation with RE-IMN.
Authors: Dirk Wähnert; Konrad L Hoffmeier; Geert von Oldenburg; Rosemarie Fröber; Gunther O Hofmann; Thomas Mückley Journal: J Bone Joint Surg Am Date: 2010-06 Impact factor: 5.284
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