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Transient retrograde interfragmentary compression technique in AO/OTA type 33-C distal femur fractures: A surgical technique and short-term radiographic follow up results
Institution:1. Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;2. Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea;1. Flinders Medical Centre, Flinders Drive, Bedford Park, SA5042, Australia;2. Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia;3. University of Amsterdam, 1012 XW, Amsterdam, The Netherlands;1. Department of Orthopaedic Surgery, Chosun University, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju, 61453, Republic of Korea;2. Department of Orthopaedic surgery, Gyeongsang National University, College of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do, 51472, Republic of Korea;1. School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel;2. Psychology Department, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
Abstract:Surgical treatment of AO/OTA type 33-C fractures is a therapeutic challenge despite advances in surgical instruments and techniques. We introduce a novel surgical technique named transient retrograde interfragmentary compression (TRIC) to help intraarticular fragment reduction in AO/OTA type 33-C fracture. We inserted a partial threaded 7.0-cannulated screw with a washer along the transepicondylar axis from the medial femoral epicondyle during the articular block reduction process of AO/OTA type 33-C fractures to strengthen the compressive force between the condylar fragments and to enhance the handling of the articular block fragment in the alignmental correction stage. Following the provisional reduction and fixation using lateral distal femur locking compression plate, TRIC screw was removed. Fifteen AO/OTA type 33-C distal femoral intraarticular fractures of thirteen patients were surgically treated using the TRIC technique. We analyzed the radiographic result of the patients by measuring the horizontal gap and vertical step-off in the postoperative radiographs. Mean horizontal fracture gap was 0.34 mm and mean vertical step-off between bicondylar fragments was 0.63 mm. The median value of the horizontal fracture gap and vertical step off was 0 and 0.46 mm, respectively. Mean time to union in the bicondylar fracture fragment was 9 week. TRIC is considered to be a valuable surgical reduction technique in the treatment of the AO/OTA 33-C type fractures.
Keywords:AO/OTA 33-C  Distal femur fracture  Surgical technique  Radiographic
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