Early Effect Of Mini-swashbuckler Approach For Treatment Of Distal Femoral Type C Fractures

Objective: To compare the clinical data of Mini-Swashbuckler approach and Swashbuckler approach in the treatment of distal femoral type C fracture,and to analyze the early effect of Mini-Swashbuckler approach in the treatment of distal femoral type C fracture.Methods: A retrospective analysis was made on 43 patients with distal femoral type C fracture in our hospital from January 2014 to June 2018.Mini-Swashbuckler approach was used in 22 cases,Swashbuckler approach was used in 21 cases,LISS plate was used for internal fixation in both groups.There was no significant difference in age,sex,cause of trauma,fracture classification,fracture side,time from injury to operation and complications between the two groups(P > 0.05).The operation time,blood loss,intraoperative fluoroscopy times,hospitalization time,fracture healing time,quality comparison of fracture reduction,and Hospital for Special Surgery(HSS)scores of the knee at 3 and 6 months were recorded,postoperative complications were recorded in both groups.Results: The operation was successfully completed in both groups.The follow-up period ranged from 6 to 8 months,with an average of 7.2 months.The operation time and fluoroscopy times in the Mini-Swashbuckler group were higher than those in the Swashbuckler group(P <0.05),but the blood loss of the Mini-Swashbuckler group was less than that of the Swashbuckler group(t=-24.043,P=0.000).There was no significant difference in hospitalization time(t = 0.277,P = 0.783)and fracture healing time(t = 0.861,P = 0.394)and quality of fracture reduction(P =0.809)between the two groups.The HSS score of the Mini-Swashbuckler group was higher than that of the Swashbuckler group at 3 and 6 months,and the difference was significant(P<0.05).There was no significant difference in incision infection,deep venous thrombosis,failure of internal fixation,dysfunction of knee joint and malunion between the two groups(P=0.698).Conclusion: Mini-Swashbuckler approach is less exposed than Swashbuckler approach,to some extent,the operation time was prolonged,and the Frequency of intraoperative fluoroscopy was increased.However,it does not increase the risk of postoperative complications.On the contrary,because of its small soft tissue injury and less blood loss,it is conducive to the recovery of knee joint function after operation.