개방성 대퇴골 원위부 골절에 대한 최소 침습적 금속판 고정술

Abstract

Purpose: We studied outcomes of minimally invasive plate osteosynthesis for open fractures of distal femur. Materials and Methods: 24 patients between september 2010 and september 2012, mean follow-up was 2 years. We surveyed injury mechanism, combined injury, AO fracture classification, Gustilo-Anderson open type, bone union period, and complications. Also, we evaluated clinical function by Knee Society Score. Results: Mostcommon injury mechanism is traffic accident, 21 cases. And patella fracture is the most common combined injury site, 10 cases. In AO classification, A3 type was 3, C1 type were 5, C2 type were 4, C3 type were 12 cases in this study. There were 6 cases open type I, 10 cases open type II, and 8 cases open type IIIa. Mean bone union period is 18weeks(12-42weeks) exception nonunion 6 cases. Severity of comminution in AO classification was statistical significance of union period and nonunion. Infection were 4 cases, and all infection cases was Gustilo-Anderson type IIIa. Mean Knee Society Score was 87.5(60-98), severe comminution fracture in AO classification was bot good clinical outcome. Conclusion: In relatively not severe comminution fracture and low size open wound fracture, minimally invasive plate osteosynthesis for open fractures of distal femur can be primary choice of treatment. But AO classification C type, and Gustilo-Anderson classification III type may need primary external fixation and sencond stage definite surgery.