Discussion About The Application And Clinic Effect Of The Longitudinal Approach Through Patella To Treat Type C Fractures Of Distal Femur

[Objective] To discuss the longitudinal approach through patella to type C fractures of distal femur and evaluate the function of the knees after operation.[Methods] Retrospective analysis of 36 patients who were operated by longitudinal approach through patella to cure type C fractures, aged from 26-72 (the average age was 49), and were followed up for 1,3,6, 12 months.Patients were followed up to record knee joint ache, range-of-motion of knees, X-ray films and to be evaluated by HSS scoring system.[Result] Among 36 patients(29 were completely followed up), knee joint ache occurred in 4 cases and the rigor of knee joint occurred in 2 cases (one case with severe head injury),4 cases walked with a cane (3 cases with infantile paralysis), without any genu varum and genu valgum deformities on the knee joint, decurtation, or bone nonunion, and all were primary healing, the evaluation of the knee function according to HSS scoring system showed excellent in 21, good in 7 and fair in 1 case, effective rate was 96.55%. The comparison of the evaluations (according to HSS scoring system) of the patients who were operated by longitudinal approach through patella recorded after 1 month,3 months,6 months and 12 months has statistical sense. And the rang-of-motion(ROM) of knees also have statistical sense (p>0.05), getting better after 3 months (p<0.01). The difference of eversion angle doesn't have statistical sense.[Conclusion]1. The advantages of longitudinal approach are as follows:sufficient exposure, excellent reduction and good internal fixation, short operation time, reduction of operation difficulties, less damage of soft tissue and less complication. So it is the appropriate route.2. The HSS scores ROM of knees and eversion angle showed that it has evident treatment effectiveness. It has scientificity and feasibility and is worth popularizing.