Abstract：
OBJECTIVE: Periprosthetic femur fractures after total knee arthroplasty in older adults are mostly treated by internal fixation. Members of the GETRAUM (French Orthopedic Trauma Society) sought to compare two surgical techniques - conventional open surgery and minimally invasive surgery - with the aim of analyzing the patients\' functional recovery. We hypothesized that a minimally invasive technique would produce better early functional outcomes with recovery of independence.
METHODS: This retrospective multicenter study of patients treated between 2009 and 2015 consisted of 90 fractures with a follow-up of 1 year. Demographic, preoperative data and the characteristics of fractures, type of fixation and the surgeon\'s experience level were collected. The endpoints were the Parker Mobility score, Katz ADL, place of residence at the time of fracture and at 6 months and one-year follow-up. All complications and one-year mortality during the follow up were searched.
RESULTS: At 6 months follow-up, the minimally invasive technique contributed to significantly better functional recovery as measured by the Parker (p < 0.05) and Katz scores (p < 0.05). However, there were no differences in these scores at one-year follow-up. The complication rate was 31% at one year follow-up. Mortality rate was 12 % (11 patients).
CONCLUSIONS: Our hypothesis was confirmed, as there was a difference between techniques that impacted functional recovery and independence, but only in the early postoperative phase. A minimally invasive technique appears to be beneficial in the short term for distal femur fractures after total knee arthroplasty but must be evaluated in a comparative and prospective study to fully confirm its reliability.
METHODS: This retrospective multicenter study of patients treated between 2009 and 2015 consisted of 90 fractures with a follow-up of 1 year. Demographic, preoperative data and the characteristics of fractures, type of fixation and the surgeon\'s experience level were collected. The endpoints were the Parker Mobility score, Katz ADL, place of residence at the time of fracture and at 6 months and one-year follow-up. All complications and one-year mortality during the follow up were searched.
RESULTS: At 6 months follow-up, the minimally invasive technique contributed to significantly better functional recovery as measured by the Parker (p < 0.05) and Katz scores (p < 0.05). However, there were no differences in these scores at one-year follow-up. The complication rate was 31% at one year follow-up. Mortality rate was 12 % (11 patients).
CONCLUSIONS: Our hypothesis was confirmed, as there was a difference between techniques that impacted functional recovery and independence, but only in the early postoperative phase. A minimally invasive technique appears to be beneficial in the short term for distal femur fractures after total knee arthroplasty but must be evaluated in a comparative and prospective study to fully confirm its reliability.
摘要：
目的：老年人全膝关节置换术后股骨假体周围骨折大多采用内固定治疗。GETRAUM（法国骨科创伤协会）的成员试图比较两种手术技术-传统的开放手术和微创手术-旨在分析患者的功能恢复。我们假设微创技术将产生更好的早期功能结果，并恢复独立性。
方法：这项对2009年至2015年接受治疗的患者进行的多中心回顾性研究包括90例骨折，随访1年。人口统计,术前资料和骨折的特点，收集固定类型和外科医生的经验水平。终点是Parker机动性评分,KatzADL,骨折时以及6个月和1年随访时的居住地。对随访期间的所有并发症和1年死亡率进行调查。
结果：随访6个月时，根据Parker(p<0.05)和Katz评分(p<0.05),微创技术有助于显著改善功能恢复.然而,在1年的随访中,这些评分没有差异.随访1年并发症发生率为31%。死亡率为12％（11例）。
结论：我们的假设得到了证实，因为影响功能恢复和独立性的技术之间存在差异，但只在术后早期。对于全膝关节置换术后的股骨远端骨折，微创技术在短期内似乎是有益的，但必须在比较和前瞻性研究中进行评估，以充分确认其可靠性。
方法：这项对2009年至2015年接受治疗的患者进行的多中心回顾性研究包括90例骨折，随访1年。人口统计,术前资料和骨折的特点，收集固定类型和外科医生的经验水平。终点是Parker机动性评分,KatzADL,骨折时以及6个月和1年随访时的居住地。对随访期间的所有并发症和1年死亡率进行调查。
结果：随访6个月时，根据Parker(p<0.05)和Katz评分(p<0.05),微创技术有助于显著改善功能恢复.然而,在1年的随访中,这些评分没有差异.随访1年并发症发生率为31%。死亡率为12％（11例）。
结论：我们的假设得到了证实，因为影响功能恢复和独立性的技术之间存在差异，但只在术后早期。对于全膝关节置换术后的股骨远端骨折，微创技术在短期内似乎是有益的，但必须在比较和前瞻性研究中进行评估，以充分确认其可靠性。
