Comparison Of The Efficacy Of Less Invasive Stabilization System And Retrograde Interlocking Intramedullary Nail In The Treatment Of C1 And C2 Fractures Of The Distal Femur

Purpose: To compare the clinical efficacy of minimally invasive internal fixation system(LISS)with retrograde interlocking intramedullary nailing(GSH)in the treatment of C1 and C2 fractures of the distal femur.Methods: The clinical data of patients with C1 and C2 distal femur fractures treated surgically with LISS or GSH at the Affiliated Hospital of Yan’an University from January2014 to December 2020 were retrospectively analyzed.64 patients met the criteria and were included in the study according to the inclusion and exclusion criteria;among them,42 were male and 22 were female;according to the AO/OTA typing,there were 28 C1 fractures and 36 C2 fractures.According to the AO/OTA classification,there were 28 C1 fractures and 36 C2 fractures;according to the surgical method,the patients were divided into Group A(LISS group)and Group B(GSH group),and Group A was treated with less invasive stabilization system(LISS);Group B was treated with retrograde interlocking intramedullary nail(RIIN/GSH).The results showed that there was no statistically significant difference between the two groups(P>0.05).The time required for surgery,intraoperative bleeding,clinical healing time of the fracture,incidence of postoperative complications and the Hospital for Special Surgery(HSS)knee score were compared between the two groups and all data were evaluated statistically.RESULTS: The mean operative time was 158.56±33.85 minutes and 153.31±35.54 minutes for the two groups,and the mean intraoperative bleeding was 685±312.05 ml and605.45±295.26 ml,respectively,with no statistically significant differences in operative time and intraoperative bleeding between the two groups(P>0.05).The mean fracture healing time was 16.64±4.26 weeks in group A(LISS group)and 14.26±3.11 weeks in group B(GSH group),with a statistically significant difference(P<0.05).The mean knee HSS scores in group A(LISS group)and group B(GSH group)were 87.25±8.36 and86.56±9.75 respectively,with excellent rates of 88.24% and 86.67% respectively,and the difference was not statistically significant(P>0.05).CONCLUSION:There was no significant difference in operative time,intraoperative bleeding and knee function between the LISS and GSH in the treatment of C1 and C2 fractures of the distal femur,with good clinical outcomes.However,the fracture healing time was shorter and more favourable with retrograde interlocking intramedullary nailing.