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Working length and proximal screw constructs in plate osteosynthesis of distal femur fractures
- Source :
- Injury. 48:2597-2601
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background The study purpose is to evaluate the working length, proximal screw density, and diaphyseal fixation mode and the correlation to fracture union after locking plate osteosynthesis of distal femoral fractures using bridge-plating technique. Methods A four-year retrospective review was performed to identify patients undergoing operative fixation of distal femur fractures with a distal femoral locking plate using bridge-plating technique for the metadiaphyseal region. Primary variables included fracture union, secondary surgery for union, plate working length, and diaphyseal screw technique and configuration. Multiple secondary variables including plate metallurgy and coronal plane fracture alignment were also collected. Results Ninety-six patients with distal femur fractures with a mean age 60 years met inclusion criteria. None of the clinical parameters were statistically significant indicators of union. Likewise, none of the following surgical technique parameters were associated with fracture union: plate metallurgy, the mean working length, screw density and number of proximal screws and screw cortices. However, diaphyseal screw technique did show statistical significance. Hybrid technique had a statistically significant higher chance of union when compared to locking (p = 0.02). All proximal locking screw constructs were 2.9 times more likely to lead to nonunion. Conclusions Plating constructs with all locking screws used in the diaphysis when bridge-plating distal femur locking plates were 2.9 times more likely to incur a nonunion. However, other factors associated with more flexible fixation constructs such as increased working length, decreased proximal screw number, and decreased proximal screw density were not significantly associated with union in this study.
- Subjects :
- Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Adolescent
Bone Screws
Nonunion
Fracture union
Fracture Fixation, Internal
Young Adult
03 medical and health sciences
Fixation (surgical)
Distal femur
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Fractures, Malunited
Aged
Retrospective Studies
General Environmental Science
Aged, 80 and over
Fracture Healing
Orthodontics
030222 orthopedics
Osteosynthesis
business.industry
Middle Aged
equipment and supplies
musculoskeletal system
medicine.disease
Surgery
Diaphysis
Treatment Outcome
medicine.anatomical_structure
Plate osteosynthesis
Coronal plane
General Earth and Planetary Sciences
Female
business
Bone Plates
Femoral Fractures
Subjects
Details
- ISSN :
- 00201383
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Injury
- Accession number :
- edsair.doi.dedup.....e2e53136cb1a85a94294d0df357bf667