Purpose: To report the peri-implant fracture rates after locked plating of distal femur fractures and examine risk factors.
Methods: Over a 7 year period, 89 AO/OTA 33A/C distal femur fractures were identified and reviewed. After excluding treatment with intramedullary nails, age under 50, those with the proximal femur protected, or those without 6 months of follow-up, 42 distal femur fractures in 41 patients, mean age 72.3 were studied. All were treated with lateral locked plating of distal femur fractures. The details of the constructs were recorded. Mean follow-up was 562 days (18.7 months).
Results: 3/42 were open injuries, 9/42 were type C, 16/42 were type A, and 17 were periprosthetic above a knee arthroplasty. Two patients were treated with a dynamic plating construct using all far-cortical locking (FCL) screws in the diaphysis. 40 patients were treated with a variety of non-dynamic diaphyseal constructs including locking, non-locking, and four with 1-2 FCL screws distally. There was one asymptomatic nonunion. 2/2 patients in the dynamically plated group experienced a peri-implant fracture versus 1/40 in the non-dynamically plated group (p = 0.001). 3/9 with an all-locked construct versus 0/25 patients with a most proximal non-locking screw experienced a fracture.
Conclusions: The overall peri-implant fracture risk was 7.1% (3/42), 3/17 patients with a locking screw most proximal experienced a peri-implant fracture, 3/9 with an all-locking construct, and 2/2 patients with a dynamic construct experienced a fracture. These findings merit additional clinical and biomechanical study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00590-022-03398-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Metastatic Neuroblastoma Masquerading as Ewing's Sarcoma on X-ray: An Imaging Puzzle in Pediatric Oncology.
J Orthop Case Rep
January 2025
Department of Pathology, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India.
Introduction: Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system. It is the most common extracranial solid tumor of childhood and accounts for up to 15% of all pediatric cancer fatalities. The manifestation of neuroblastoma is variable depending on the location of the tumor and the presence or absence of paraneoplastic syndromes.
View Article and Find Full Text PDFOutcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient.
J Orthop Case Rep
January 2025
Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.
Introduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be performed percutaneously and expeditiously even in extremely old patients; therefore, patient age should not be a limiting factor in choosing this construct to allow for immediate weight-bearing.
Case Report: The patient was a 99-year-old female who presented to the emergency room after a fall.
Minimally Invasive Plate Osteosynthesis Using Locking Plates for Distal Femur Fractures: A Retrospective Analysis of 40 Cases.
J Orthop Case Rep
January 2025
Department of Orthopedics, Sree Balaji Medical College and Hospital, BIHER, Chromepet, Chennai, Tamil Nadu, India.
Introduction: Distal femur fractures present significant surgical challenges due to their complex anatomy and limited soft tissue coverage. Minimally invasive plate osteosynthesis (MIPO) has emerged as a promising alternative to traditional open techniques, aiming to reduce soft-tissue damage while maintaining stable fixation, particularly when used with locking plates.
Materials And Methods: This retrospective study analyzed 40 consecutive patients with distal femur fractures treated with MIPO and locking plates.
Giant Cell Tumor of Distal Radius Treated with Wide Local Excision and Reconstruction with Ipsilateral Proximal Fibular Autograft - A Follow-Up.
J Orthop Case Rep
January 2025
Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Introduction: Giant cell tumour or osteoclastoma is benign, locally aggressive tumor with bone destruction and with malignant potential. It accounts for 5% of all primary bone tumor and occurs in skeletally mature individuals in the age group of 30 to 45 with peak incidence in the 3rd decade. GCT is more common in females.
View Article and Find Full Text PDFReconstruction of the Tibial Stump After Fibulectomy.
Orthop Res Rev
January 2025
Scientific Department, Scientific and Research Institute of Rehabilitation of National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
The formation of a functional tibial stump after combat injuries with extensive tissue damage is sometimes difficult. We describe a case of reconstruction of the tibial stump after a mine-blast injury. In this case, the fibula was completely removed as a result of fracture, and the tibia was amputated at the border of the upper and middle thirds.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!