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Lateral locked plating for distal femur fractures by low-energy trauma: what makes a difference in healing?

Authors
Kim, SM | Yeom, JW | Song, HK  | Hwang, KT | Hwang, JH | Yoo, JH
Citation
International orthopaedics, 42(12). : 2907-2914, 2018
Journal Title
International orthopaedics
ISSN
0341-26951432-5195
Abstract
PURPOSE: The objective of this study is to investigate healing outcome of lateral locked plating for distal femoral fractures caused by low-energy trauma. In addition, we sought to determine predictable factors associated with fracture healing time.
METHODS: Seventy-three patients (73 fractures) with distal femur fractures (AO/OTA type 33) caused by low-energy trauma were recruited. The mean age of patients was 69.8 years (range, 43-87 years). All fractures were stabilized by less invasive osteosynthesis with anatomical periarticular locking system. Patients were followed up for mean 17.3 months (range, 6-44 months).
RESULTS: Of the 73 fractures, 52 (71.2%) fractures showed bony union within 6 months after the index surgery while the remaining 21 (28.8%) fractures showed delayed union or received revision surgery prior to complete healing. Although overall healing rate from the initial surgery was 93.2% (68/73), which seems to be satisfactory, the rate of surgical complications was 11.0% (8/73). Of all 73 fractures, seven received further surgery including three re-osteosynthesis. On multivariable analysis, plate-screw density at the fracture site was an independent predictable factor associated with the problematic healing.
CONCLUSIONS: Our findings suggest that complications related to increased healing time and fixation construct are not infrequent and ongoing problems in managing low-energy distal femur fractures. Specifically, plate-screw density at the fracture site has a significant influence on healing time in these fractures.
Keywords
DOI
10.1007/s00264-018-3881-3
PMID
29549401
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
Ajou Authors
송, 형근
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