[Treatment of type C3.3 distal femoral fractures with double-plating fixation via U-shaped incision].

OBJECTIVE: To investigate the efficacy of double-plating fixation via U-shaped incision in the treatment of type C3.3 distal femoral fractures. METHODS: From July 2006 to February 2009, 11 cases of type C3.3 distal femoral fractures were treated, including 5 open fractures and 6 closed fractures. Among them, there were 7 males and 4 females with an average age of 43 years (range, 27-55 years). The locations were left side in 6 cases and right side in 5 cases. Fracture was caused by traffic accident in 8 cases and falling from height in 3 cases. The time from injury to hospitalization was 30 minutes to 7 days. After bone traction for 3 to 8 days, the operations were performed by double-plating fixation via U-shaped incision, and autograft of iliac bone or allogeneic bone grafting. RESULTS: The average time of operation was 128 minutes (range, 105-150 minutes). The average blood loss during operation was 344 mL (range, 290-380 mL). Shallow local skin flap necrosis occurred in 2 cases, and incision healed by first intention in others patients. All patients were followed up 22 months on average (range, 12-36 months). The bone union was achieved within 3-6 months (4.4 months on average). No implant loosening or refracture was found. According to Merchan et al criteria for knee joint function evaluation, the results were excellent in 4 cases, good in 5 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 81.8%. CONCLUSION: The double-plating fixation via U-shaped incision has the advantages of better exposure, great convenience to manipulation, anatomical reduction, and rigid fixation. It provides an effective treatment for type C3.3 distal femoral fracture. However, its operation indications and operating instructions should be strictly followed.