J Korean Fract Soc.  2016 Oct;29(4):242-249. 10.12671/jkfs.2016.29.4.242.

The Mid-Term Result after Osteosynthesis of Intra-Articular Fractures of Distal Femur

• Park SG
• Moon JJ
• Shon OJ

• KMID: 2355429
• DOI: http://doi.org/10.12671/jkfs.2016.29.4.242

Abstract

PURPOSE
This study was to evaluate the radiological and clinical mid-term results and the presence of post-traumatic osteoarthritis after osteosynthesis in patients under the age of 50 years undergoing osteosynthesis for distal femur intra-articular fractures (AO/OTA 33-B & C) from high-energy trauma.
MATERIALS AND METHODS
Between January 2008 and January 2013, a total of twenty-one patients with more than three years of follow-up were enrolled. Recovery of the alignment of the lower extremity, union period, and the presence of post-traumatic osteoarthritis were confirmed by follow-up radiographs. Clinically, the range of motion, pain on fracture lesion, and Knee Society score (KSS) were evaluated.
RESULTS
The average duration of union was 18.2 weeks (10-28 weeks), and the alignment of the lower extremity was within normal range in all patients. Seven patients showed post-traumatic osteoarthritis at the final follow-up after more than three years. The presence of post-traumatic osteoarthritis was associated with the classification of fractures, coronal plane fracture, and age. The average range of motion, knee score among KSS, and function score at the last follow-up were 128.7°, 86.1, and 85.1, all showing a greater improvement when compared with the one-year follow-up scores.
CONCLUSION
The mid-term result was radiologically and clinically satisfactory. Furthermore, only 33.3% of patients showed a slight progress of post-traumatic osteoarthritis, which critically effects the prognosis.

Keyword

Distal femur fracture; Intra-articular fractures; Post-traumatic osteoarthritis; Mid-term

MeSH Terms

Classification
Femur*
Follow-Up Studies
Humans
Intra-Articular Fractures*
Knee
Lower Extremity
Osteoarthritis
Prognosis
Range of Motion, Articular
Reference Values

Figure

• 

  Fig. 1 A 46-year-old female with metaphyseal simple and complete articular fracture with coronal plane fracture, who was injured by a fall (AO/OTA 33-C3). (A) Anteroposterior and lateral radiograph of the right distal femur fracture. (B) Computed tomography. (C) Radiographs, obtained immediately operatively, show an internal fixation. (D) Radiographs obtained at 10 months after surgery show complete bony union at the fracture site. (E) Radiographs obtained at 14 months after surgery show a device removal status. (F) Radiographs obtained at 4 years after surgery show normal alignment and no post-traumatic osteoarthritis progression.

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