Abstract
BackgroundOur preliminary retrospective study assessed outcomes after the use of Ni-Ti arched shape-memory connector (ASC) combined with partially threaded cancellous screws (PTCS) to repair coronal plane supracondylar-condylar femoral fractures.MethodsTwenty-one patients (16 men and 5 women) with a mean age of 34.1 years (range, 28 to 44 years) with coronal plane supracondylar and condylar fractures of the distal femur were included in this study. Each patient underwent open reduction and internal fixation using the ASC and PTCS. Active functional exercises with restricted weight bearing were initiated the first postoperative day. A gradual increase in weight bearing status and range of motion was permitted and subjects progressed to full weight bearing by 8 weeks. Surgical time, blood loss, postoperative knee range of motion, American Knee Society Scores (KSS), and postoperative complications were assessed.ResultsThe mean surgical time was 75 mins (range, 45 to 100 mins) and average blood loss was 105 ml (range, 35 to 130 ml). Mean follow-up was 65 months (range, 22 to 90 months). No subjects demonstrated evidence of osteonecrosis or arthritis at the final follow-up. The mean KSS was excellent (≥85) in 8 subjects, good (70-84) in 11 subjects, and fair (60-69) in 2 subjects. The mean active range of motion of knee flexion at final follow-up was 100 degrees (range, 85 to 110 degrees).ConclusionsASC combined with PTCS can serve as an effective means for managing comminuted femoral fractures that extend from the condyle to the supracondylar region. However, further prospective comparative studies and biomechanical analyses are needed to evaluate long-term outcomes using these materials.
Highlights
Our preliminary retrospective study assessed outcomes after the use of Ni-Ti arched shape-memory connector (ASC) combined with partially threaded cancellous screws (PTCS) to repair coronal plane supracondylarcondylar femoral fractures
Most of these cases were fixated using lag-screws for isolated Hoffa fractures, the strength of this fixation may be insufficient for the comminuted fragments at the supracondylar distal femur region
We reviewed the literature to highlight the importance of accurately detecting these fractures as well as describe the role of early and rigid internal fixation on patient outcomes
Summary
Our preliminary retrospective study assessed outcomes after the use of Ni-Ti arched shape-memory connector (ASC) combined with partially threaded cancellous screws (PTCS) to repair coronal plane supracondylarcondylar femoral fractures. This condition is rare and accounts for less than 1% of all femoral fractures, as it typically results only from highvelocity injuries [2,3] Despite this low incidence, Nork and colleagues recently reported a 38% incidence of coronal plane supracondylar-intercondylar distal femoral fractures in adults [4]. Most of these cases were fixated using lag-screws for isolated Hoffa fractures, the strength of this fixation may be insufficient for the comminuted fragments at the supracondylar distal femur region Given that this is a rare type of fracture, the coronal fracture line that crosses the condyle to the supracondyle of distal femur has not been described by typical AO/OTA or Letenneur classification [8,9]. The use of Ni-Ti Alloy for the treatment of distal femur fractures has not been evaluated
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