RESUMO
Seventeen, supracondylar femur fractures in 15 severely osteoporotic patients (average age, 81.9 years) were treated with a 95 degree supracondylar plate and dynamic compression screw supplemented with intramedullary methyl methacrylate and massive cancellous bone graft harvested from the distal femoral metaphysis. Interfragmentary compression and rigid fracture fixation was obtained in all cases with the use of the A-O compression device. Patients were allowed early protected weight bearing without external immobilization. At follow-up observation (average, 2.1 years), bony union was noted in all cases, and knee flexion averaged 100.4 degrees. There were no malunions or cases of implant failure. Complications included two early postoperative deaths and three femur fractures above the plate. This technique was effective in rapidly restoring patient mobility while avoiding the complications of implant failure.
Assuntos
Cimentos Ósseos , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Osteoporose/complicações , Idoso , Idoso de 80 Anos ou mais , Transplante Ósseo , Feminino , Fraturas do Fêmur/complicações , Seguimentos , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Metilmetacrilato , MetilmetacrilatosRESUMO
Forty-two open tibial fractures were treated with anterior half-pin frame fixation, weight bearing as tolerated, and early reconstruction of the soft tissue envelope. Thirty fractures were followed to completion of therapy. The infection rate was 7.1%, nonunion rate, 3.0%, and pin tract infection rate, 0.5%. Problems of malunion (23.3%) and of secondary fractures around lag screws (17.6%) may be reduced by early cancellous bone grafting and limited use of minimal internal fixation.