The Clinical Comparison Dynamic Condylar Screw With The Condylar Buttress Plate In The Distal Femur Fractures

Generally distal femur refers to the distal femur within 15 cm, including Supracondylar and femoral condyle. Femoral closer cylindrical distal femur was swelling, "speakers" shape, and was rotating with the ends extending a femoral condyle. Femoral condyle diameter than the diameter of a long, on both sides of the outside diameter of condylar longer. Femoral condyle capsule around the festival, ligament, muscle and tendon attachment, fractures pieces by these organizations pull hard reset, reset difficult to rear a distal femoral and popliteal sciatic nerve arteriovenous serious fracture, can cause injury.Fractures of the distal femur fracture of the femur as a whole about 5%. Distal femoral fractures more high-energy injury, injury mechanism was considered to be outside the power of flip or spin axial loads, often leads to distal femur related anatomical structures seriously damaged, and three-dimensional plane articular fractures, and more debris is not the size a collapse overturned displacement, serious bone defects, reduction and fixation difficulties, often difficult to achieve anatomical reduction, handling more difficult, more complications, treatment is not always satisfactory.With CT, DR, MRI, and other imaging equipment used, the complexity of the distal femur fracture diagnosis continuously improved. Surgical treatment of a new and improved method of fixation material development, from the traditional conservative treatment of the transition to a positive surgery. The purpose of surgery is to achieve articular fractures anatomical reduction, and restoration of the axial rotation fracture arranged femoral condyle of the femur and firmly fixed, as well as the early postoperative functional training, quickly restored the function of the knee. Based on the dynamic condylar screw with the support plate in the femur distal femur fractures of the efficacy compared to the treatment of distal femoral fractures to provide certain clinical reference.Used in this study were followed up for 56 patients, according to different treatment methods were divided into two groups: dynamic condylar screw (DCS) group: 16 males and 9 females cases 21 cases of traffic accidents, fall injury three cases, a pressure injury Cases; two cases of open fractures, closed fractures in 23 cases, with ipsilateral patellar fracture three cases, the ipsilateral tibial plateau fracture two cases, two cases of ipsilateral meniscus injury, and ipsilateral patellar fracture of tibial plateau one case of ipsilateral one case of anterior cruciate ligament injury, brain injury combined two cases, one case of the merger abdominal injuries, one case of spinal fractures; A fracture 16 cases, 9 cases of C-type fracture. Condylar buttress plate (CBP) group: 24 male and female 7 cases; traffic injuries in 26 cases, five cases fall injury; one case of open fractures, and 30 cases closed fracture, with ipsilateral patellar fracture two cases, the ipsilateral tibial plateau fracture and anterior cruciate ligament and meniscus injury four cases, the merger chest injury cases, one case of the merger of other fractures. A fracture in 19 cases, 12 cases of C-type fracture. Fixation material selection Changzhou City Comfort Medical Devices Limited production of dynamic condylar screw compression and femoral condyle support plate; allogeneic bone grafting material Hill Xiaorui Limited production of biological material allogeneic bone. Two patients were given open reduction and dynamic condylar screw condylar buttress plate fixation. Injuries are a time to visit h ~ 2d. Two groups of patients were followed up for 10 to 18 months, with an average of 14 months. In patients after one month, three months, six months, 12 months and 18 months of outpatient review, inspection knee, hip and ankle function, and X-ray photography to observe and judge fracture healing.The results showed that two groups of patients with primary healing incision, no skin necrosis, and no implant break loose. Case respectively in the two groups A and C fractures time of the surgery, are drawn P <0.05, there were significant differences; fracture bleeding volume comparison, are drawn P <0.05, there were significant differences; fracture of After the drainage respectively comparison, are drawn P> 0.05, the difference was not statistically significant. A-type fracture clinical healing time, P <0.05, the difference was significant. C-type fracture healing time after clinical, P> 0.05, the difference was not statistically significant; after fracture malunion rates were compared were drawn P> 0.05, the difference was not statistically significant; postoperative knee function were relatively good, P were obtained> 0.05, the difference was not statistically significant.According to the treatment results concluded that the A-type dynamic condylar fracture nail in the operative time, blood loss and postoperative clinical fracture healing time are better than condylar buttress plate, we should first consider the application. C in the treatment of fractures, surgical time and blood loss, superior application of dynamic condylar screw condylar buttress plate, the two could be given priority under the circumstances the use of dynamic condylar screw. But for C3 fracture, condylar buttress plate fixation can be solid, satisfactory outcome. In comminuted fracture of the distal femur surgery as a result of multiple fractures to end the cancellous bone, and more crushing, should be complemented by a local graft, and promote the healing of fractures, will be satisfied with the effect, it is for clinical use.