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Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach
BACKGROUND: The treatment of distal femur fractures represents a challenging task. General and local factors, including bone quality, articular surface involvement, fracture comminution, associated soft tissue injuries and ultimately fixation system, all play a role in the final clinical outcome. Cu...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mattioli 1885
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972876/ https://www.ncbi.nlm.nih.gov/pubmed/35315401 http://dx.doi.org/10.23750/abm.v93i1.12091 |
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author | Ghirardelli, Stefano Touloupakis, Georgios Theodorakis, Emmanouil Antonini, Guido Violante, Bruno Indelli, Pier Francesco |
author_facet | Ghirardelli, Stefano Touloupakis, Georgios Theodorakis, Emmanouil Antonini, Guido Violante, Bruno Indelli, Pier Francesco |
author_sort | Ghirardelli, Stefano |
collection | PubMed |
description | BACKGROUND: The treatment of distal femur fractures represents a challenging task. General and local factors, including bone quality, articular surface involvement, fracture comminution, associated soft tissue injuries and ultimately fixation system, all play a role in the final clinical outcome. Current surgical approaches often undermine patellar vascularization and integrity of the extensor apparatus, not guaranteeing sufficient visualization of the medial condyle. This technical note presents the efficacy and safety of a new surgical technique to address distal femoral fractures. METHODS: The original “swashbuckler” surgical approach was modified in order to obtain a better visualization of the lateral and medial femoral condyles without affecting the knee extensor mechanism and the anastomotic arterial supply of the patella. This modified surgical approach was utilized in a consecutive series of patients presenting with a AO Foundation/Orthopaedic Trauma Association (AO/OTA) 33 distal femur or periprosthetic fracture of the knee. The last follow-up functional outcome was recorded according to Sanders scoring system. RESULTS: Twelve patients with a mean age of 67, 8 years were included in this series. The same, modified “swashbuckler” surgical approach was applied in all cases. Multiple internal fixation techniques, including a single lateral plate, a combination of a lateral and medial plate, a single lateral plate associated with lag screws, were used to obtain a satisfactory stabilization of the fracture site. All patients were reviewed at a minimum one-year follow up (median 15 months): all patients returned to their previous life style or work activity; average Sanders Score was 34.9. No major intraoperative or postoperative complications were recorded. CONCLUSIONS: The modified swashbuckler approach allows anatomical reduction and appropriate fixation with a theoretically reduced severance of the blood supply to the patella and preserves the integrity of extensor mechanism. (www.actabiomedica.it) |
format | Online Article Text |
id | pubmed-8972876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Mattioli 1885 |
record_format | MEDLINE/PubMed |
spelling | pubmed-89728762022-04-15 Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach Ghirardelli, Stefano Touloupakis, Georgios Theodorakis, Emmanouil Antonini, Guido Violante, Bruno Indelli, Pier Francesco Acta Biomed Original Article BACKGROUND: The treatment of distal femur fractures represents a challenging task. General and local factors, including bone quality, articular surface involvement, fracture comminution, associated soft tissue injuries and ultimately fixation system, all play a role in the final clinical outcome. Current surgical approaches often undermine patellar vascularization and integrity of the extensor apparatus, not guaranteeing sufficient visualization of the medial condyle. This technical note presents the efficacy and safety of a new surgical technique to address distal femoral fractures. METHODS: The original “swashbuckler” surgical approach was modified in order to obtain a better visualization of the lateral and medial femoral condyles without affecting the knee extensor mechanism and the anastomotic arterial supply of the patella. This modified surgical approach was utilized in a consecutive series of patients presenting with a AO Foundation/Orthopaedic Trauma Association (AO/OTA) 33 distal femur or periprosthetic fracture of the knee. The last follow-up functional outcome was recorded according to Sanders scoring system. RESULTS: Twelve patients with a mean age of 67, 8 years were included in this series. The same, modified “swashbuckler” surgical approach was applied in all cases. Multiple internal fixation techniques, including a single lateral plate, a combination of a lateral and medial plate, a single lateral plate associated with lag screws, were used to obtain a satisfactory stabilization of the fracture site. All patients were reviewed at a minimum one-year follow up (median 15 months): all patients returned to their previous life style or work activity; average Sanders Score was 34.9. No major intraoperative or postoperative complications were recorded. CONCLUSIONS: The modified swashbuckler approach allows anatomical reduction and appropriate fixation with a theoretically reduced severance of the blood supply to the patella and preserves the integrity of extensor mechanism. (www.actabiomedica.it) Mattioli 1885 2022 2022-03-14 /pmc/articles/PMC8972876/ /pubmed/35315401 http://dx.doi.org/10.23750/abm.v93i1.12091 Text en Copyright: © 2021 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License |
spellingShingle | Original Article Ghirardelli, Stefano Touloupakis, Georgios Theodorakis, Emmanouil Antonini, Guido Violante, Bruno Indelli, Pier Francesco Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title | Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title_full | Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title_fullStr | Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title_full_unstemmed | Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title_short | Distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
title_sort | distal femur fractures: management and outcomes by a modified anterolateral swashbuckler approach |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972876/ https://www.ncbi.nlm.nih.gov/pubmed/35315401 http://dx.doi.org/10.23750/abm.v93i1.12091 |
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