股骨远端骨折功能预后的不同入路研究

Someswar Deb, Thejaswini Karanth, Pranathi R, Ravikumar K
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引用次数: 0

摘要

通常的损伤机制是高能量创伤,更常见的是年轻人群的道路交通事故(RTA)和家庭事故,更常见的是老年人的跌倒。据报道,股骨远端骨折具有较高的发病率和死亡率。考虑到股骨远端骨折累及关节面比例较高,许多研究建议除常规临床检查外,通过影像学检查,包括CT扫描评估。据报道,高达55%的股骨远端骨折涉及关节内表面。股骨远端骨折相对罕见,但据说后果严重。据报道,股骨远端骨折在所有骨折中的发生率约为0.4%,约占股骨骨折的3%。许多研究还建议,搏动的存在可能会误导临床医生,因为它是没有血管损伤的不良指标,并建议进行适当的检查以排除这种严重的相关损伤。同样的作者也建议在急诊室进行股神经阻滞。在过去的几十年里,各种内固定方法不断发展,并在临床实践中用于治疗股骨远端骨折。西方国家进行了许多前瞻性研究,以评估许多这些技术的长期功能结果。但在印度等发展中国家发表的关于这一主题的文献相对较少。由于结果可能在很大程度上取决于人群特征、外科医生的技术技能和术前的支持治疗,因此需要一小时来生成针对特定环境的证据,以指导未来的临床决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Study on Various Approaches of Functional Outcome of Distal Femur Fractures
The usual mechanism of injury is high energy trauma, more often a road traffic accident (RTA) in a younger population and a domestic accident, more often a fall in elderly people. Distal femoral fractures are reported to have high morbidity and mortality associated with them. Many studies have recommended, through radiological examination, including evaluation by CT scan, considering the high proportion of distal femur fractures involving intraarticular surface, apart from routine clinical examination. As high as 55% of the distal femur fractures are reported to involve intra-articular surface.Fractures of the distal femur are relatively rare but are said to have severe consequences. The reported frequency of distal femur fractures among overall fractures is about 0.4%, and they constitute about 3% of femoral fractures. Many studies have also advised that the presence of pulsation may mislead the clinician, as it is a poor indicator of the absence of vascular injury and have recommended proper tests to rule out this serious associated injury. A femoral nerve block is indicated and recommended by the same authors in the emergency room. Various internal fixation methods have evolved over the last few decades and are in clinical practice to target distal femur fractures. Many prospective studies have been conducted in western countries to assess the long term functional outcomes of many of these techniques. But the amount of literature published on the subject relatively less from developing countries like India. Since the outcomes may heavily depend on the population characteristics, the technical skill of the surgeons and the support therapy in the preoperative period, it is the need of the hour to generate evidence specific to a particular setting, to guide future clinical decisions. 
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