ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 GUOZhimin , GONGXingxing , LIYanwei , QIUXiaochun , ZHANGMeng , SHANGGUANTiancheng , AOQingfang , LIUQiang

Orthopedic Center of Chinese PLA, the 175 th Hospital of Chinese PLA, Zhangzhou Fujian, 363000, P. R. China;

Corresponding author：

GUOZhimin, Email: gzmin175@163.com

Keywords：

Comminuted fractures of femoral condyles; Anatomical plate; Cortical bone plate allograft

DOI：

10.7507/1002-1892.20150002

Video：

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Objective To summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. Methods Between January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. Results Superficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. Conclusion Anatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.

Citation： GUOZhimin, GONGXingxing, LIYanwei, QIUXiaochun, ZHANGMeng, SHANGGUANTiancheng, AOQingfang, LIUQiang. ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(1): 6-9. doi: 10.7507/1002-1892.20150002 Copy

1.	李程, 张立. AO股骨髁支撑钢板内固定在股骨远端复杂骨折的应用. 中国修复重建外科杂志, 2006, 20(7):706-708.
2.	朱新炜, 李云恺, 左金良, 等. 股骨远端C型骨折锁定钢板内固定术后不愈合的原因及治疗体会. 实用医学杂志, 2012, 28(4):618-619.
3.	赵滨, 聂洪崚, 陈洪强, 等. 锁定钢板治疗股骨远端骨折失误7例分析. 中国矫形外科杂志, 2013, 21(20):1373-1375.
4.	刘云鹏, 刘沂. 骨与关节损伤和疾病的诊断分类及功能评定标准. 北京:清华大学出版社, 2002:77-78.
5.	Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones:retrospec-tive and prospective analyses. J Bone Joint Surg (Am), 1976, 58(4):453-458.
6.	孙世荃. 同种异体骨移植的免疫排斥. 中华骨科杂志, 2001, 21(5):308-310.
7.	Merchan EC, Maestu PR, Blanco RP. Blade-plating of closed displaced supracondylar fractures of the distal femur with the AO system. J Trauma, 1992, 32(2):174-178.
8.	李永斌, 袁华军, 何忠, 等. 切开复位解剖钢板内固定治疗股骨远端复杂骨折. 中华创伤骨科杂志, 2006, 8(2):119-122.
9.	王传舜, 李豪青, 伍凯, 等. 肱骨近端锁定接骨板结合异体骨植骨治疗外翻嵌插型四部分肱骨近端骨折. 中华创伤骨科杂志, 2013, 15(10):909-911.
10.	李康国, 张志明, 蒋定华. LISS钢板治疗股骨远端C型骨折. 临床骨科杂志, 2013, 16(6):669-670.
11.	李卫康, 戚浩天, 赵永杰, 等. 影响股骨髁间骨折术后膝关节功能的相关因素分析. 中国矫形外科杂志, 2013, 21(24):2443-2448.
12.	李松军, 王兆杰, 谭伟源, 等. 股骨髁部复杂骨折内固定后膝关节功能受限的多元逐步回归分析. 中国组织工程研究, 2013, 17(52):9029-9034.
13.	贝朝涌, 王锐英, 唐际存, 等. 股骨远端骨折术后膝关节功能恢复影响因素分析. 中国修复重建外科杂志, 2009, 23(9):1053-1057.
14.	Palmu SA, Lohman M, Paukku RT, et al. Childhood femoral fracture can lead to premature knee-joint arthritis. 21-year follow-up results:a retrospective study. Acta Orthop, 2013, 84(1):71-75.
15.	Chandler HP, King D, Limbird R, et al. The use of cortical allograft struts for fixation of fractures associated with well-fixed total joint prostheses. Semin Arthroplasty, 1993, 4(2):99-107.
16.	Haddad FS, Duncan CP, Berry DJ, et al. Periprosthetic femoral fractures around well-fixed implants:use of cortical onlay allografts with or without a plate. J Bone Joint Surg (Am), 2002, 84(6):945-950.
17.	翟文亮, 丁真奇, 练克俭, 等. 钢板结合异体骨板治疗长骨干骨囊肿病理性骨折. 临床骨科杂志, 2001, 4(3):212-214.
18.	周勇刚, 金志刚, 王岩, 等. 异体皮质骨支撑植骨在髋关节股骨翻修术中的应用. 中华关节外科杂志:电子版, 2008, 2(5):484-490.
19.	Wang JW, Weng LH. Treatment of distal femoral nonunion with internal fixation cortical allograft struts and autogenous bone grafting. J Bone Joint Surg (Am), 2003, 85(3):436-440.
20.	王臻, 刘继忠, 黄长明, 等. 大段同种异体皮质骨移植后哈佛管内的骨诱导成骨研究. 中华骨科杂志, 2002, 22(5):313-317.
21.	陈璟昆, 彭昌贵, 李日旺, 等. 胫骨远端骨折LISS术后结合中药熏洗治疗对踝关节功能恢复的影响. 广东医学, 2013, 34(17):2711-2713.

1. 李程, 张立. AO股骨髁支撑钢板内固定在股骨远端复杂骨折的应用. 中国修复重建外科杂志, 2006, 20(7):706-708.
2. 朱新炜, 李云恺, 左金良, 等. 股骨远端C型骨折锁定钢板内固定术后不愈合的原因及治疗体会. 实用医学杂志, 2012, 28(4):618-619.
3. 赵滨, 聂洪崚, 陈洪强, 等. 锁定钢板治疗股骨远端骨折失误7例分析. 中国矫形外科杂志, 2013, 21(20):1373-1375.
4. 刘云鹏, 刘沂. 骨与关节损伤和疾病的诊断分类及功能评定标准. 北京:清华大学出版社, 2002:77-78.
5. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones:retrospec-tive and prospective analyses. J Bone Joint Surg (Am), 1976, 58(4):453-458.
6. 孙世荃. 同种异体骨移植的免疫排斥. 中华骨科杂志, 2001, 21(5):308-310.
7. Merchan EC, Maestu PR, Blanco RP. Blade-plating of closed displaced supracondylar fractures of the distal femur with the AO system. J Trauma, 1992, 32(2):174-178.
8. 李永斌, 袁华军, 何忠, 等. 切开复位解剖钢板内固定治疗股骨远端复杂骨折. 中华创伤骨科杂志, 2006, 8(2):119-122.
9. 王传舜, 李豪青, 伍凯, 等. 肱骨近端锁定接骨板结合异体骨植骨治疗外翻嵌插型四部分肱骨近端骨折. 中华创伤骨科杂志, 2013, 15(10):909-911.
10. 李康国, 张志明, 蒋定华. LISS钢板治疗股骨远端C型骨折. 临床骨科杂志, 2013, 16(6):669-670.
11. 李卫康, 戚浩天, 赵永杰, 等. 影响股骨髁间骨折术后膝关节功能的相关因素分析. 中国矫形外科杂志, 2013, 21(24):2443-2448.
12. 李松军, 王兆杰, 谭伟源, 等. 股骨髁部复杂骨折内固定后膝关节功能受限的多元逐步回归分析. 中国组织工程研究, 2013, 17(52):9029-9034.
13. 贝朝涌, 王锐英, 唐际存, 等. 股骨远端骨折术后膝关节功能恢复影响因素分析. 中国修复重建外科杂志, 2009, 23(9):1053-1057.
14. Palmu SA, Lohman M, Paukku RT, et al. Childhood femoral fracture can lead to premature knee-joint arthritis. 21-year follow-up results:a retrospective study. Acta Orthop, 2013, 84(1):71-75.
15. Chandler HP, King D, Limbird R, et al. The use of cortical allograft struts for fixation of fractures associated with well-fixed total joint prostheses. Semin Arthroplasty, 1993, 4(2):99-107.
16. Haddad FS, Duncan CP, Berry DJ, et al. Periprosthetic femoral fractures around well-fixed implants:use of cortical onlay allografts with or without a plate. J Bone Joint Surg (Am), 2002, 84(6):945-950.
17. 翟文亮, 丁真奇, 练克俭, 等. 钢板结合异体骨板治疗长骨干骨囊肿病理性骨折. 临床骨科杂志, 2001, 4(3):212-214.
18. 周勇刚, 金志刚, 王岩, 等. 异体皮质骨支撑植骨在髋关节股骨翻修术中的应用. 中华关节外科杂志:电子版, 2008, 2(5):484-490.
19. Wang JW, Weng LH. Treatment of distal femoral nonunion with internal fixation cortical allograft struts and autogenous bone grafting. J Bone Joint Surg (Am), 2003, 85(3):436-440.
20. 王臻, 刘继忠, 黄长明, 等. 大段同种异体皮质骨移植后哈佛管内的骨诱导成骨研究. 中华骨科杂志, 2002, 22(5):313-317.
21. 陈璟昆, 彭昌贵, 李日旺, 等. 胫骨远端骨折LISS术后结合中药熏洗治疗对踝关节功能恢复的影响. 广东医学, 2013, 34(17):2711-2713.

Chinese Journal of Reparative and Reconstructive Surgery

ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES

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