Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort

Masahiro Kiyono, Tomoyuki Noda, Hiroshi Nagano, Takashi Maehara, Yasuaki Yamakawa, Yusuke Mochizuki, Takahiko Uchino, Suguru Yokoo, Koji Demiya, Kenta Saiga, Yasunori Shimamura, Toshifumi Ozaki

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Abstract

Background: Plate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method. Methods: This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them. Results: Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes. Conclusions: We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.

Original languageEnglish
Article number384
JournalJournal of Orthopaedic Surgery and Research
Volume14
Issue number1
DOIs
Publication statusPublished - Nov 26 2019

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Keywords

  • Bridging plate
  • Distal femur fracture
  • Empty hole
  • Locking compression plate
  • Relative stability

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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