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Sagittal Unicondylar Fracture of the Femur on Nail of Küntscher

Open Journal of Orthopedics 2017年第7期7卷 192-197页

作者： Tchatchuang Paul urich tambekou Batarabadja Bakriga Noufanangue Kombate Atchi Walla Anani Abalo Assang Michel Dossim Department of Orthopaedics Tokoin Teaching Hospital Lomé Togo Afagna Hospital Afagnan Togo

Unicondylar fractures of the femur on osteosynthesis equipment are a particular entity in terms of the lesion mechanisms and therapeutic difficulties. We report this case because of its exceptional nature and discuss the mechanism of occurrence. It was a lateral sagittal unicondylar fracture of the femur on a nail of Küntscher that had been laid for medio-diaphyseal fracture. The causal mechanism was direct. A double screwing on each side of the nail after an open reduction followed by an early rehabilitation was carried out. Consolidation was obtained at 3 months and the nail removed at 18 months with a good functional knee result. Anatomical reduction and fixation allowing early rehabilitation represent a guarantee for a good long-term result.

关键词： Fracture Unicondylar Femur Nail of Küntscher Surgical Treatment

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Watson-Jones Anatomical Approach for Open Reduction and Internal Fixation of Proximal Femoral Fractures without Image Intensifier in a Low-Resource Setting

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Open Journal of Orthopedics 2024年第4期14卷 173-186页

作者： Loïc Fonkoue Gaspary Fodjeu Kennedy Olivier Muluem Olivier Ngongang Theophile Nana Marie Ange Ngo Yamben DésiréAkaba urich tambekou Daniel Eone Handy Department of Orthopaedics and Trauma Yaound&#233 General Hospital Yaound&#233 Cameroon. Department of Surgery and Specialities University of Yaound&#233 1 Yaound&#233 Cameroon Department of Orthopaedics and Trauma Yaound&#233 Emergency Center Yaound&#233 Cameroon Department of Orthopaedics and Trauma Yaound&#233 Central Hospital Yaound&#233 Cameroon

Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas o

关键词： Proximal Femoral Fracture Watson-Jones Approach Dynamic Hip Screw Low Resource Setting

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