Journal article
Nail Plate Combination Fixation Versus Lateral Locked Plating for Distal Femur Fractures: A Multicenter Experience
Journal of orthopaedic trauma, Vol.37(11), pp.562-567
11/2023
DOI: 10.1097/BOT.0000000000002661
PMID: 37828687
Abstract
Objectives: To (1) report on clinical, radiographic, and functional outcomes after nail-plate fixation (NPF) of distal femur fractures and (2) compare outcomes after NPF with a propensity matched cohort of fractures treated with single precontoured lateral locking plates. Design: Multicenter retrospective cohort study. Setting: Ten Level 1 trauma centers. Patients/Participants: Patients with OTA/AO 33A or 33C fractures. Intervention: Fixation with (1) retrograde intramedullary nail combined with lateral locking plate (n = 33) or (2) single precontoured lateral locking plate alone (n = 867). Main Outcome Measurements: The main outcomes of interest were all-cause unplanned reoperation and presence of varus collapse at final follow-up. Results: One nail-plate patient underwent unplanned reoperation excluding infection and 2 underwent reoperation for infection at an average of 57 weeks after surgery. No nail-plate patients required unplanned reoperation to promote union and none exhibited varus collapse. More than 90% were ambulatory with no or minimal pain at final follow-up. In comparison, 7 of the 30 matched lateral locked plating patients underwent all-cause unplanned reoperation excluding infection (23% vs. 3%, P = 0.023), and an additional 3 lateral locked plating patients were found to have varus collapse on final radiographs (10% vs. 0%, P = 0.069). Conclusions: Despite a high proportion of high-energy, open, and comminuted fractures, no NPF patients underwent unplanned reoperation to promote union or demonstrated varus collapse. Propensity score matched analysis revealed significantly lower rates of nonunion for NPF compared with lateral locked plating alone. Larger studies are needed to identify which distal femur fracture patients would most benefit from NPF. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Details
- Title: Subtitle
- Nail Plate Combination Fixation Versus Lateral Locked Plating for Distal Femur Fractures: A Multicenter Experience
- Creators
- Brendan Y. Shi - University of California, Los AngelesDane J. Brodke - University of California, Los AngelesNathan O'Hara - Adams Cowley Shock Trauma Center at the University of MarylandSai Devana - University of California, Los AngelesAdolfo Hernandez - University of California, Los AngelesCynthia Burke - University of MaryJayesh Gupta - University of MaryNatasha McKibben - University of MaryRobert O'Toole - Adams Cowley Shock Trauma Center at the University of MarylandJohn Morellato - University of MississippiHunter Gillon - University of MississippiMurphy Walters - University of MississippiColby Barber - Virginia Commonwealth UniversityPaul Perdue - Virginia Commonwealth UniversityGraham Dekeyser - University of UtahLillia Steffenson - University of UtahLucas Marchand - University of UtahStephen Shymon - Harbor–UCLA Medical CenterMarshall James Fairres - Harbor–UCLA Medical CenterLoren Black - Oregon Health & Science UniversityZachary Working - Oregon Health & Science UniversityErika Roddy - University of California, San FranciscoAshraf El Naga - University of California, San FranciscoMatthew Hogue - University of IowaTrevor Gulbrandsen - University of IowaOmar Atassi - Baylor College of MedicineThomas Mitchell - Baylor College of MedicineChristopher Lee - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic trauma, Vol.37(11), pp.562-567
- DOI
- 10.1097/BOT.0000000000002661
- PMID
- 37828687
- ISSN
- 0890-5339
- eISSN
- 1531-2291
- Language
- English
- Date published
- 11/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984480348102771
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