Abstract
This is a retrospective study of 18 patients who had ipsilateral femoral and tibial fractures. They were treated by the retrograde femoral and antegrade tibial intramedullary nail from a single incision in the knee. The average time for union of femoral shaft fractures was 27.6 (18–40) weeks. One patient required antegrade nailing with a bone graft due to metal failure after using the short nail. Two tibial fractures required bone grafting due to bone loss, with an initial open fracture. The average time for union of tibial fractures was 24.5 (18–30) weeks. Functional results using the Karlstrom–Olerud criteria were excellent in 14, good in three, and acceptable in one. The only acceptable result was in a supra- and inter-condylar femoral fracture, with protrusion of the nail tip into the knee joint, which created moderate limitation of knee motion. Simultaneous retrograde femoral and antegrade tibial nailing with a single incision in the knee can achieve satisfactory results in the management of these types of fracture.
Résumé
Etude rétrospective de 18 patients qui avaient une fracture fémorale et tibiale ipsilatérales. Ils ont été traités par enclouage centromédullaire rétrograde fémoral et enclouage antérograde tibial, en utilisant une seule incision sur le genou. Le temps moyen de consolidation des fractures diaphysaires fémorales était de 27,6 (18–40) semaines. Un malade a nécessité un enclouage antérograde avec greffe osseuse à cause de l’échec dû à l’utilisation d’un clou trop court. Deux fractures tibiales ont nécessité une greffe osseuse à cause de la perte de substance dûe à une fracture ouverte initiale. Le temps moyen de consolidation des fractures tibiales était de 24,5 (18–30) semaines. Les résultats fonctionnels, avec les critères de Karlstrom–Olerud étaient excellents dans 14 cas, bon dans trois et médiocre dans un cas. Le seul résultat médiocre était aprés une fracture sus et intercondylienne fémorale, avec issue de l’extrémité du clou dans l’articulation du genou, créant une limitation modéré de la mobilité. L’enclouage simultané rétrograde fémoral et antérograde tibial avec une seule incision sur le genou peut donner des résultats satisfaisants dans la gestion de ces fractures.
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This study was conducted at Kyungpook National University Hospital, Daegu, Korea.
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Oh, CW., Oh, JK., Min, WK. et al. Management of ipsilateral femoral and tibial fractures. International Orthopaedics (SICOT) 29, 245–250 (2005). https://doi.org/10.1007/s00264-005-0661-7
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DOI: https://doi.org/10.1007/s00264-005-0661-7