A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture
Abstract Background For treating distal femur fractures, minimally invasive plating techniques with indirect reduction of the metadiaphysis while minimizing the damage to the peripheral soft tissue has gradually become the standard. However, all the current approaches use a straight or lazy curved i...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03076-7 |
| _version_ | 1798026235219017728 |
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| author | Tsung-Mu Wu Chi-Sheng Chien Sheng-Hui Lin |
| author_facet | Tsung-Mu Wu Chi-Sheng Chien Sheng-Hui Lin |
| author_sort | Tsung-Mu Wu |
| collection | DOAJ |
| description | Abstract Background For treating distal femur fractures, minimally invasive plating techniques with indirect reduction of the metadiaphysis while minimizing the damage to the peripheral soft tissue has gradually become the standard. However, all the current approaches use a straight or lazy curved incision adjacent to the patella or along the lateral side of the femur, which allows for easier proximal extension but increases the incision length. Methods In order to achieve a more physiological and esthetic outcome while leaving the metadiaphysis untouched, we developed an approach using a lambda-shaped incision, which sacrifices the potential for proximal extension but preserves much more peripheral soft tissue. Here, we describe our technique and our experience with it in 19 patients (12 men and 7 women). Results Fractures healing by first intention was observed in all patients. The postoperative knee range of motion can reach up to 90° in most of the patient. Clinically, 9 patients had excellent results, 6 had good results, 3 had fair results, and 2 had loss of follow-up. Conclusions Our minimally invasive lambda-incision approach allows sufficient visual access to almost the entire joint surface, including the entire lateral femoral condyle, trochlear surface, and distal medial condyle, where reduction is required. The lambda incision provides a much larger window than that offered by a same-length straight incision. The vertical turn at the mid-patellar level parallels the skin crease and geniculate artery, reducing soft tissue damage and resulting in a smooth healing wound. Moreover, plate and distal screw insertion is easier than that through a straight incision. Because the metadiaphysis region is mostly left untouched, ideal fracture-healing environment is preserved. |
| first_indexed | 2024-04-11T18:32:03Z |
| format | Article |
| id | doaj.art-6abed2de9f43426794532a2b1973b519 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T18:32:03Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-6abed2de9f43426794532a2b1973b5192022-12-22T04:09:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-03-011711810.1186/s13018-022-03076-7A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fractureTsung-Mu Wu0Chi-Sheng Chien1Sheng-Hui Lin2Orthopedic Department, Chi-Mei Medical CenterOrthopedic Department, Chi-Mei Medical CenterOrthopedic Department, Chi-Mei Medical CenterAbstract Background For treating distal femur fractures, minimally invasive plating techniques with indirect reduction of the metadiaphysis while minimizing the damage to the peripheral soft tissue has gradually become the standard. However, all the current approaches use a straight or lazy curved incision adjacent to the patella or along the lateral side of the femur, which allows for easier proximal extension but increases the incision length. Methods In order to achieve a more physiological and esthetic outcome while leaving the metadiaphysis untouched, we developed an approach using a lambda-shaped incision, which sacrifices the potential for proximal extension but preserves much more peripheral soft tissue. Here, we describe our technique and our experience with it in 19 patients (12 men and 7 women). Results Fractures healing by first intention was observed in all patients. The postoperative knee range of motion can reach up to 90° in most of the patient. Clinically, 9 patients had excellent results, 6 had good results, 3 had fair results, and 2 had loss of follow-up. Conclusions Our minimally invasive lambda-incision approach allows sufficient visual access to almost the entire joint surface, including the entire lateral femoral condyle, trochlear surface, and distal medial condyle, where reduction is required. The lambda incision provides a much larger window than that offered by a same-length straight incision. The vertical turn at the mid-patellar level parallels the skin crease and geniculate artery, reducing soft tissue damage and resulting in a smooth healing wound. Moreover, plate and distal screw insertion is easier than that through a straight incision. Because the metadiaphysis region is mostly left untouched, ideal fracture-healing environment is preserved.https://doi.org/10.1186/s13018-022-03076-7Distal femurSupracondylar fractureIntercondylar fractureMinimally invasive surgeryMinimally invasive plate osteosynthesisNovel |
| spellingShingle | Tsung-Mu Wu Chi-Sheng Chien Sheng-Hui Lin A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture Journal of Orthopaedic Surgery and Research Distal femur Supracondylar fracture Intercondylar fracture Minimally invasive surgery Minimally invasive plate osteosynthesis Novel |
| title | A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture |
| title_full | A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture |
| title_fullStr | A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture |
| title_full_unstemmed | A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture |
| title_short | A novel approach to distal femur: a minimally invasive technique for supracondylar and intercondylar fracture |
| title_sort | novel approach to distal femur a minimally invasive technique for supracondylar and intercondylar fracture |
| topic | Distal femur Supracondylar fracture Intercondylar fracture Minimally invasive surgery Minimally invasive plate osteosynthesis Novel |
| url | https://doi.org/10.1186/s13018-022-03076-7 |
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