The clinical efficacy of retrograde tibial intramedullary nail combined with lateral less invasive stabilization system in the treatment of distal femoral fractures
10.3760/cma.j.cn121113-20240828-00474
- VernacularTitle:胫骨逆行髓内钉联合微创内固定系统治疗股骨远端骨折
- Author:
Weizhen XU
1
;
Zhenqi DING
1
;
Hui LIU
1
;
Jinhui ZHANG
1
;
Yuanfei XIONG
1
;
Weibin LIN
1
;
Jin WU
1
Author Information
1. 第九〇九医院（厦门大学附属东南医院）骨科，漳州 363000
- Publication Type:Journal Article
- Keywords:
Femoral fractures;
Fracture fixation, intramedullary;
Internal fixators;
Bone plates
- From:
Chinese Journal of Orthopaedics
2025;45(4):197-204
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of retrograde tibial intramedullary nail (RTN) combined with less invasive stabilization system (LISS) in the treatment of distal femoral fractures.Methods:A retrospective analysis was conducted on the data of 11 patients with distal femoral fractures who underwent RTN combined with LISS locking plate treatment at the 909th Hospital from June 2021 to December 2022. There were 5 males and 6 females, with an average age of 56.5±17.5 years. The fracture types were AO/OTA 33A2 in 2 cases, A3 in 2 cases, C1 in 2 cases, and C2 in 2 cases. There were 3 cases of periprosthetic femoral fractures after total knee arthroplasty (TKA), all classified as Rorabeck type Ⅱ. They were treated with retrograde intramedullary nailing of the tibia combined with a minimally invasive lateral internal fixation system. The operation time, intraoperative blood loss, fracture healing time, full weight-bearing time, femorotibial angle, range of motion (ROM) of the knee joint, Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) for pain, and complications were recorded.Results:The operation was successfully completed in all 11 cases. The operation time was 98.3±9.0 min (range 83-115 min), and the intraoperative blood loss was 167.8±24.3 ml (range 120-210 ml). All 11 cases were followed up for 11.0±1.9 months (range 9-15 months). The healing time of 11 cases was 5.3±0.8 months (range 4-6 months) after operation. The time of complete weight-bearing activity after operation was 55.7±6.5 d (range 46-67 d). At the last follow-up, the femoral-tibial angle of 11 cases was 171.2°±1.8° (range 169°-174°), the ROM of knee joint was 129.5°±4.7° (range 120°-135°), and the HSS score was 86.8±6.9 points (range 69-95 points). There were no major complications except for one case of superficial infection of surgical incision after operation.Conclusion:RTN combined with lateral LISS locking plate showed good clinical effect with the advantages of less trauma, reliable fixation, rapid recovery, less postoperative complications.
