Contralateral ilium harvesting for C3 fracture of distal femur is beneficial to early rehabilitation of knee joint

doi:10.3877/cma.j.issn.1674-134X.2019.02.005

Abstract

Abstract:

Objective

To investigate the influence to knee joint rehabilitation with the ipsilateral or contralateral ilium harvesting in the distal femur C3 fracture surgery.

Methods

According to the inclusion and exclusion criteria, patients who underwent surgical treatment of distal femoral C3 fractures from April 2013 to July 2015 were prospectively selected. According to the donor site, the patients underwent ipsilateral or contralateral iliac harvesting alternately, were then grouped in ipsilateral harvesting group and contralateral harvesting group. Theatre time, time interval of knee joint active extension to 10° and flexion to 120°, visual analog score(VAS) of the donor site at three months post-operatively were compared respectively. Complications such as incision redness, delayed incision healing, hematoma, infection, iliac crest avulsion fracture were recorded. The t-test or rank sum test was used for the measurement data. The chi-square test was used for the count data. The Kaplan-Meier method was used for survival analysis of the knee joint with active extension to 10° and flexion to 120°, and the Breslow test was performed.

Results

A total of 12 patients in the ipsilateral harvesting group and 11 patients in the contralateral harvesting group were included. The time of follow-up were 18 (14, 21) months for the ipsilateral harvesting group and 15 (13, 20) months for the contralateral harvesting group. Compared to the ipsilateral harvesting group, the theatre time of the contralateral harvesting group was significantly less(t=2.169, P<0.05), the median survival time of knee active extension to 10° and flexion to 120° were less (χ²=7.999, P<0.05; χ²=9.325, P<0.05 respectively). The pain relief in the donor area were better in contralateral harvesting group than that in the ipsilateral harvesting group(t=8.910, P<0.01). There were three cases of red incision, with one in the ipsilateral harvesting group and two in the other one. All the incisions healed after treatment. During the follow-up period, no hematoma, infection or iliac crest avulsion fracture of the donor area happened.

Conclusion

Harvesting of the contralateral ilium for the C3 fracture of distal femur is beneficial to the early rehabilitation of knee joint.

Key words: Femoral fractures, Fractures, comminuted, Bone transplantation, Knee injuries, Prospective studies

Haosen Yang, Xin Huang, Bin Xia, Yunji Yang, Jinhai Zhao, Nianchi Wen. Contralateral ilium harvesting for C3 fracture of distal femur is beneficial to early rehabilitation of knee joint[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(02): 157-160,229.

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References 21

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分组	例数	年龄[岁，M(P₂₅，P₇₅)]	性别(男/女)
同侧取骨组	12	38(32，50)	10/2
对侧取骨组	11	35(29，46)	7/4
统计值	?	Z＝－0.678	χ²＝1.155
P值	?	> 0.05	>0.05

分组	例数	年龄[岁，M(P₂₅，P₇₅)]	性别(男/女)
同侧取骨组	12	38(32，50)	10/2
对侧取骨组	11	35(29，46)	7/4
统计值	?	Z＝－0.678	χ²＝1.155
P值	?	> 0.05	>0.05

分组	例数	手术时长[min，(±s)]	患侧膝关节主动屈伸至特定角度所需时间[月，M(P₂₅，P₇₅)]		术后3个月末取骨区VAS(±s)	取骨区并发症情况(例)
分组	例数	手术时长[min，(±s)]	伸直至10°	屈曲至120°	术后3个月末取骨区VAS(±s)	取骨区并发症情况(例)
同侧取骨组	12	154.4±16.9	9.2(7，12)	5.1(3，8)	2.4±0.4	1
对侧取骨组	11	133.5±13.5	5.0(3，9)	3.3(1，5)	1.3±0.2	2
统计值	?	t＝2.169	Z＝7.999	Z＝9.325	t＝8.910	－
P值	?	<0.05	<0.05	<0.05	<0.01	－

分组	例数	手术时长[min，(±s)]	患侧膝关节主动屈伸至特定角度所需时间[月，M(P₂₅，P₇₅)]		术后3个月末取骨区VAS(±s)	取骨区并发症情况(例)
分组	例数	手术时长[min，(±s)]	伸直至10°	屈曲至120°	术后3个月末取骨区VAS(±s)	取骨区并发症情况(例)
同侧取骨组	12	154.4±16.9	9.2(7，12)	5.1(3，8)	2.4±0.4	1
对侧取骨组	11	133.5±13.5	5.0(3，9)	3.3(1，5)	1.3±0.2	2
统计值	?	t＝2.169	Z＝7.999	Z＝9.325	t＝8.910	－
P值	?	<0.05	<0.05	<0.05	<0.01	－

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