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COMPARISON OF SURGICAL RESULTS OF RETROGRADE INTRAMEDULLARY NAILING AND FIXING WITH PLATE SCREW IN SUPRACONDYLAR FEMUR FRACTURES

Year 2022, Volume: 29 Issue: 3, 284 - 290, 30.09.2022
https://doi.org/10.17343/sdutfd.1055414

Abstract

Objective
Supracondylar femur fractures in adults are fractures
that involve or do not involve the articular surface, and
although there are different surgical fixation options,
they
are a type of fracture that is not easy to treat. Since
the soft tissue and periosteum viability could not be
preserved due to wide incisions in plate applications
performed in these fractures, and results such as
nonunion were encountered, surgeons preferred the
retrograde intramedullary nailing method.
Material and Method
In our study, two groups of patients who were fixed
with retrograde intramedullary nailing and plate were
compared. Twenty patients who were treated in our
clinic between 2005 and 2016 were included in the
study, 11 of these patients were treated with plate
screws and 9 with retrograde nails. The subjective
satisfaction level of these patients was investigated
and compared in terms of postoperative VAS, HSS,
Neer scores, development of arthrosis, quadriceps
muscle strength, thigh atrophy, and shortness.
Results
In comparison, there was no statistically significant
difference between the two groups in terms of
subjective satisfaction level, postoperative VAS, HSS,
Neer scores, development of arthrosis, quadriceps
muscle strength, thigh atrophy, and shortness.
Conclusion
Plate and screw treatment and retrograde nailing
methods are reliable and good treatment methods in
supracondylar femur fractures, both methods have
advantages and disadvantages, but there is no major
difference between the two methods in terms of the
patient in the long run.

References

  • 1. Çağlar, Ö. and C. Ilgar, Suprakondiler Femur Kırıkları Güncel Tedavisi. Turkiye Klinikleri Orthopaedics and Traumatology - Special Topics, 2015. 8(61): p. 5.
  • 2. Schatzker, J., Fractures of the distal femur revisited. Clin Orthop Relat Res, 1998(347): p. 43-56.
  • 3. EGE, R., in TRAVMATOLOJİ. 2003, kadıoğlu matbaasu: Ankara. p. 3197 3217/ 3366-3379.
  • 4. Uhthoff, H.K., P. Poitras, and D.S. Backman, Internal plate fixation of fractures: short history and recent developments. J Orthop Sci, 2006. 11(2): p. 118-26.
  • 5. Leung, K.S., et al., Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. J Bone Joint Surg Am, 1991. 73(3): p. 332-40.
  • 6. Neer, C.S., 2nd, S.A. Grantham, and M.L. Shelton, Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Joint Surg Am, 1967. 49(4): p. 591-613.
  • 7. Helfet, D.L., Fracture of the Distal Femur, in Skeletal Trauma. 1992, WB Saunders. p. 1643-83.
  • 8. DA, W., Supracondylar and intercondylar fractures of the femur, in Fracture in adults, G.D. Rockwood CA, Bucholz RW Editor. 1991, J.B. Lippincott Comp: Philadelphia. p. 1778-97.
  • 9. Mize, R.D., R.W. Bucholz, and D.P. Grogan, Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am, 1982. 64(6): p. 871-9.
  • 10. Olerud, S., Operative treatment of supracondylar-condylar fracture of the adult femur. J Bone Joint Surg, 1967: p. 591-613.
  • 11. Yang, R.-S., H.-C. Liu, and T. Liu, Supracondylar fractures of the femur. The Journal of trauma, 1990. 30(3): p. 315-319.
  • 12. Pritchett, J.W., Supracondylar fractures of the femur. Clinical orthopaedics and related research, 1984(184): p. 173-177.
  • 13. Chiron, H.S., et al., Fractures of the distal third of the femur treated by internal fixation. Clinical Orthopaedics and Related Research (1976-2007), 1974. 100: p. 160-170.
  • 14. Giles, J.B., et al., Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. J Bone Joint Surg Am, 1982. 64(6): p. 864-70.
  • 15. Brown, A. and J.C. D'Arcy, Internal fixation for supracondylar fractures of the femur in the elderly patient. J Bone Joint Surg Br, 1971. 53(3): p. 420-4.
  • 16. Chin, K.R., et al., Retrograde nailing of femur fractures in patients with myelopathy and who are nonambulatory. Clin Orthop Relat Res, 2000(373): p. 218-26.
  • 17. Aglietti p. , B.r., Fractures of the Femoral Condyles, in Surgery of the Knee. 1993, Churchill - Livingstone: New York. p. 983- 1034.
  • 18. AP, W., Fractures of the lower extremity, in Campbell’s operative orthopaedics, C. ST, Editor. 1998, Mosby-YearBook Inc: St. Louis. p. 2042-179.
  • 19. Kolmert, L. and K. Wulff, Epidemiology and treatment of distal femoral fractures in adults. Acta Orthopaedica Scandinavica, 1982. 53(6): p. 957-962.
  • 20. Shelbourne, K.D. and F.R. Brueckmann, Rush-pin fixation of supracondylar and intercondylar fractures of the femur. The Journal of bone and joint surgery. American volume, 1982. 64(2): p. 161-169.
  • 21. Papagiannopoulos, G. and D. Clement, Treatment of fractures of the distal third of the femur. A prospective trial of the Derby intramedullary nail. The Journal of bone and joint surgery. British volume, 1987. 69(1): p. 67-70.
  • 22. Siliski, J.M., Fractures of the distal femur constitute a heterogenous On an anterior view of the distal femur, the weight. Traumatic Disorders of the Knee, 1994: p. 105.
  • 23. Shahcheraghi, G.H. and H.R. Doroodchi, Supracondylar fracture of the femur: closed or open reduction? The Journal of trauma, 1993. 34(4): p. 499-502.
  • 24. Jeon, I.-H., et al., Minimally invasive percutaneous plating of distal femoral fractures using the dynamic condylar screw. Journal of Trauma and Acute Care Surgery, 2004. 57(5): p. 1048-1052.
  • 25. Dunlop, D. and I. Brenkel, The supracondylar intramedullary nail in elderly patients with distal femoral fractures. Injury, 1999. 30(7): p. 475-484.
  • 26. Saw, A. and C. Lau, Supracondylar nailing for difficult distal femur fractures. Journal of Orthopaedic Surgery, 2003. 11(2): p. 141-147.
  • 27. Leung, K., et al., Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. JBJS, 1991. 73(3): p. 332-340.
  • 28. Egund, N. and L. Kolmert, Deformities, gonarthrosis and function after distal femoral fractures. Acta Orthopaedica Scandinavica, 1982. 53(6): p. 963-974.

SUPRAKONDİLER FEMUR KIRIKLARINDA RETROGRAD İNTRAMEDÜLLER ÇİVİLEME VE PLAK VİDA İLE TESPİT CERRAHİ SONUÇLARININ KARŞILAŞTIRILMASI

Year 2022, Volume: 29 Issue: 3, 284 - 290, 30.09.2022
https://doi.org/10.17343/sdutfd.1055414

Abstract

Amaç
Erişkinlerde görülen suprakondiler femur kırıkları eklem
yüzeyini ilgilendiren veya ilgilendirmeyen kırıklar
olup farklı cerrahi tespit seçenekleri bulunmasına
rağmen, tedavisi kolay olmayan bir kırık çeşididir. Bu
kırıklarda yapılan plak uygulamalarında geniş insizyonlar
sebebiyle yumuşak doku ve periost canlılığı
korunamayıp kaynamama gibi sonuçlarla karşılaşıldığından
dolayı cerrahlar tarafından retrograd intramedullar
çivileme metoduna bir yönelim meydana
gelmiştir.
Gereç ve Yöntem
Çalışmamızda retrograd intrameduller çivileme ve
plak ile tespit edilen iki grup hastada karşılaştırma yapıldı.
2005-2016 tarihleri arasında kliniğimizde tedavi
olan 20 hasta çalışmaya dahil edildi, bu hastaların 11’i
plak ile 9’u ise retrograd çivi ile tedavi edildi. Bu hastalarda
subjektif memnuniyet derecesi ameliyat sonrası
VAS, HSS, Neer skorları, artroz gelişimi, kuadriseps
kası gücü, uyluk atrofisi ve kısalık açısından araştırıldı
ve karşılaştırıldı.
Bulgular
Yapılan karşılaştırmalarda her iki tedavi grubu arasında
memnuniyet derecesi postoperatif VAS, HSS,
Neer skorları, artroz gelişimi, kuadriseps kası gücü,
uyluk kas atrofisi ve kısalık açısından istatiksel olarak
anlamlı bir fark saptanmadı.
Sonuç
Suprakondiler femur kırıklarında plak-vida ile tedavi
ve retrograd çivileme yöntemleri güvenilir tedavi yöntemleridirler,
her iki yöntemin avantaj ve dezavantajları
mevcut olup uzun vadede değerlendirildiğinde her
iki yönteminde suprakondiler femur kırıkları tedavisinde
başarılı olduğunu söyleyebiliriz.

References

  • 1. Çağlar, Ö. and C. Ilgar, Suprakondiler Femur Kırıkları Güncel Tedavisi. Turkiye Klinikleri Orthopaedics and Traumatology - Special Topics, 2015. 8(61): p. 5.
  • 2. Schatzker, J., Fractures of the distal femur revisited. Clin Orthop Relat Res, 1998(347): p. 43-56.
  • 3. EGE, R., in TRAVMATOLOJİ. 2003, kadıoğlu matbaasu: Ankara. p. 3197 3217/ 3366-3379.
  • 4. Uhthoff, H.K., P. Poitras, and D.S. Backman, Internal plate fixation of fractures: short history and recent developments. J Orthop Sci, 2006. 11(2): p. 118-26.
  • 5. Leung, K.S., et al., Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. J Bone Joint Surg Am, 1991. 73(3): p. 332-40.
  • 6. Neer, C.S., 2nd, S.A. Grantham, and M.L. Shelton, Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Joint Surg Am, 1967. 49(4): p. 591-613.
  • 7. Helfet, D.L., Fracture of the Distal Femur, in Skeletal Trauma. 1992, WB Saunders. p. 1643-83.
  • 8. DA, W., Supracondylar and intercondylar fractures of the femur, in Fracture in adults, G.D. Rockwood CA, Bucholz RW Editor. 1991, J.B. Lippincott Comp: Philadelphia. p. 1778-97.
  • 9. Mize, R.D., R.W. Bucholz, and D.P. Grogan, Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am, 1982. 64(6): p. 871-9.
  • 10. Olerud, S., Operative treatment of supracondylar-condylar fracture of the adult femur. J Bone Joint Surg, 1967: p. 591-613.
  • 11. Yang, R.-S., H.-C. Liu, and T. Liu, Supracondylar fractures of the femur. The Journal of trauma, 1990. 30(3): p. 315-319.
  • 12. Pritchett, J.W., Supracondylar fractures of the femur. Clinical orthopaedics and related research, 1984(184): p. 173-177.
  • 13. Chiron, H.S., et al., Fractures of the distal third of the femur treated by internal fixation. Clinical Orthopaedics and Related Research (1976-2007), 1974. 100: p. 160-170.
  • 14. Giles, J.B., et al., Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. J Bone Joint Surg Am, 1982. 64(6): p. 864-70.
  • 15. Brown, A. and J.C. D'Arcy, Internal fixation for supracondylar fractures of the femur in the elderly patient. J Bone Joint Surg Br, 1971. 53(3): p. 420-4.
  • 16. Chin, K.R., et al., Retrograde nailing of femur fractures in patients with myelopathy and who are nonambulatory. Clin Orthop Relat Res, 2000(373): p. 218-26.
  • 17. Aglietti p. , B.r., Fractures of the Femoral Condyles, in Surgery of the Knee. 1993, Churchill - Livingstone: New York. p. 983- 1034.
  • 18. AP, W., Fractures of the lower extremity, in Campbell’s operative orthopaedics, C. ST, Editor. 1998, Mosby-YearBook Inc: St. Louis. p. 2042-179.
  • 19. Kolmert, L. and K. Wulff, Epidemiology and treatment of distal femoral fractures in adults. Acta Orthopaedica Scandinavica, 1982. 53(6): p. 957-962.
  • 20. Shelbourne, K.D. and F.R. Brueckmann, Rush-pin fixation of supracondylar and intercondylar fractures of the femur. The Journal of bone and joint surgery. American volume, 1982. 64(2): p. 161-169.
  • 21. Papagiannopoulos, G. and D. Clement, Treatment of fractures of the distal third of the femur. A prospective trial of the Derby intramedullary nail. The Journal of bone and joint surgery. British volume, 1987. 69(1): p. 67-70.
  • 22. Siliski, J.M., Fractures of the distal femur constitute a heterogenous On an anterior view of the distal femur, the weight. Traumatic Disorders of the Knee, 1994: p. 105.
  • 23. Shahcheraghi, G.H. and H.R. Doroodchi, Supracondylar fracture of the femur: closed or open reduction? The Journal of trauma, 1993. 34(4): p. 499-502.
  • 24. Jeon, I.-H., et al., Minimally invasive percutaneous plating of distal femoral fractures using the dynamic condylar screw. Journal of Trauma and Acute Care Surgery, 2004. 57(5): p. 1048-1052.
  • 25. Dunlop, D. and I. Brenkel, The supracondylar intramedullary nail in elderly patients with distal femoral fractures. Injury, 1999. 30(7): p. 475-484.
  • 26. Saw, A. and C. Lau, Supracondylar nailing for difficult distal femur fractures. Journal of Orthopaedic Surgery, 2003. 11(2): p. 141-147.
  • 27. Leung, K., et al., Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. JBJS, 1991. 73(3): p. 332-340.
  • 28. Egund, N. and L. Kolmert, Deformities, gonarthrosis and function after distal femoral fractures. Acta Orthopaedica Scandinavica, 1982. 53(6): p. 963-974.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Araştırma Makaleleri
Authors

Eşref Terzi This is me 0000-0002-2933-7323

Nafiz Bilsel This is me 0000-0003-2692-0350

Aybars Kıvrak 0000-0003-0657-2213

Recep Dinçer 0000-0001-9088-3940

Publication Date September 30, 2022
Submission Date January 9, 2022
Acceptance Date August 1, 2022
Published in Issue Year 2022 Volume: 29 Issue: 3

Cite

Vancouver Terzi E, Bilsel N, Kıvrak A, Dinçer R. SUPRAKONDİLER FEMUR KIRIKLARINDA RETROGRAD İNTRAMEDÜLLER ÇİVİLEME VE PLAK VİDA İLE TESPİT CERRAHİ SONUÇLARININ KARŞILAŞTIRILMASI. Med J SDU. 2022;29(3):284-90.

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