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Comminuted distal femur closed fractures: a new application of the Ilizarov concept of compression–distraction

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

The treatment of intra-articular distal femur fractures with severe metaphyseal comminution is challenging. It is important to choose a technique that provides secure fixation, minimum tissue handling, and early ambulation. The aim of this work was to evaluate the outcomes of application of Ilizarov concept as an early definitive treatment of comminuted distal femur closed fractures.

Patients and methods

A total of 17 male patients (mean age 28.53 ± 6.33 years) presented with comminuted distal femur fractures (with 10 type C2 and 7 type C3-2 fractures according to AO/ASIF system) were included in this prospective study. Initial fixation of the articular fragments was done by inter-fragmentary screws, percutaneously through a limited open approach, and stabilization was completed by Ilizarov fixator. The procedure included acute shortening, through the comminution, followed by gradual re-distraction to compensate the created shortening. Radiological and functional results were assessed according to ASAMI evaluation system.

Results

The mean amount of intra-operative shortening was 3.68 ± 0.53 cm. The mean external fixation index was 37.24 ± 2.53 days/cm. The mean follow-up period was 18.18 ± 1.91 months. All fractures united primarily in an average 137.65 ± 4.12 days, with no evident angular deformity or limb-length discrepancy. None of the cases required a second major procedure or bone graft. The functional results were excellent in three cases, good in 12, and fair in two patients.

Conclusions

The Ilizarov concept of acute compression–distraction is a valuable alternative for the treatment of distal femur fractures with severe metaphyseal comminution.

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Authors and Affiliations

  1. Orthopedic and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

    Ahmad El-Tantawy & Ashraf Atef

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  1. Ahmad El-Tantawy
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  2. Ashraf Atef
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Correspondence to Ahmad El-Tantawy.

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El-Tantawy, A., Atef, A. Comminuted distal femur closed fractures: a new application of the Ilizarov concept of compression–distraction. Eur J Orthop Surg Traumatol 25, 555–562 (2015). https://doi.org/10.1007/s00590-014-1561-6

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  • DOI: https://doi.org/10.1007/s00590-014-1561-6

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