The management of secondary fractures of the femur by the Ilizarov method

Abstract

Femur fractures below endoprostheses or upper borderline of the hip of the angular plate after treatment of a supracondylar fracture of femur can be catastrophic occurence. These type of rare fracture were treated by Ilizarov s method of percutaneous transosseous osteosynthesis, between May 1993 and September 1993, at the Department of Orthopaedic Surgery and Traumatology Clinic in Ege University. The object of our treatment with the Ilizarov fixator in addition to the anatomical reconstruction is the mobility of the adjacent joints and an immediate ambulatory function with partial and even complete weight bearing. The stategy of our management is lead by the basic ideas reduction and fixation. Our average operating time is 1 hour 30 min. For one or two days, the period of pain and edema, the patient will have mobilising exercises in bed. Afterwards he will begin walking with weight bearing of 15 kg and resume quickly the full weight bearing. The first check X-ray will be done the third postoperative day. The average time of the treatment with Ilizarov apparatus lasted 17 weeks. The results proved that this type of treatment can be an alternative method for these type of fractures.

Özet

Biri total kalça protezi, diğeri suprakondiler femur kırığı sonrası uygulanan plaklamadan sonra implantlar ile sağlam kemik sınırında femur kırığı oluşan iki olguda skopi kontrolunda kapalı redüksiyon ve İlizarov eksternal fiksatörü ile transossöz osteosentez uygulandı. İzleme süreleri sırası ile 24, 25 hafta olan olgularda 16 ile 18 haftalarda kemik iyieşmesi ve kemik öncesi fonksiyonel duruma dönüş elde edildi. Alınan sonuçlar kemik iyileşmesi ve fonksiyonel açılardan yeterli oldu. Bu tip yaralanmalarda kemik odağı açılmadan kapalı redüksiyon ile uygulanan İlizarov eksternal fiksatorunun bir tedavi seçeneği oluşturduğu saptandı.