Comparison of Clinical Efficacy of Lateral and Lateral and Medial Double-plating Fixation of Distal Femoral Fractures

Bai, Zhibiao; Gao, Shichang; Hu, Zhenming; Liang, Anlin

doi:10.1038/s41598-018-23268-8

Cited by 17 publications

(28 citation statements)

References 19 publications

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“…No significant differences in the mean operation time, intraoperative haemorrhage or fracture-healing time were observed. Good to excellent knee function 1 year postoperatively was found [ 29 ]. While fracture healing was achieved in all cases in the double-plating group, there was one non-union in the single-plating group [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Good to excellent knee function 1 year postoperatively was found [ 29 ]. While fracture healing was achieved in all cases in the double-plating group, there was one non-union in the single-plating group [ 29 ]. Summarising all 108 cases, the overall complication rate was 33.3%.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies described outcomes of case series with double plating of distal femoral fractures [2,[29][30][31][32][33]. A total of 156 distal femoral fractures (AO [Arbeitsgemeinschaft für Osteosynthesefragen] 33 A-B and 33-C2 and 33-C3 fractures) were included ( Table 3).…”

Section: Distal Femoral Fracturementioning

confidence: 99%

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Union rates and functional outcome of double plating of the femur: systematic review of the literature

Lodde

Raschke

Stolberg-Stolberg

et al. 2021

Arch Orthop Trauma Surg

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Background The optimal treatment strategy for the surgical management of femur fractures and non-unions remains unknown. The aim of this study is to assess union rates, complications and outcome after femoral double plating. Treatment of shaft, distal, periprosthetic fractures and pathological proximal femur fractures as well as femoral non-unions with double plating were evaluated. Methods A systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was conducted. Published literature reporting on the treatment and clinical outcome of femoral fractures and non-unions with double plating was identified. In total, 24 studies with 436 cases of double plating, 64 cases of single plating, 84 cases of intramedullary nailing (IM), and 1 interfragmentary screw treatment met the inclusion criteria of this systematic review. The evaluated literature was published between 1991 and 2020. Results Double plating of femoral fractures achieved high healing rates and few complications were reported. It displayed significantly less intraoperative haemorrhage, shorter surgery time reduced risk of malunion in polytraumatised patients when compared to IM. Fracture healing rate of double-plating distal femoral fractures was 88.0%. However, there were no significant differences regarding fracture healing, complication or functional outcome when compared to single plating. Treatment of periprosthetic fractures with double plating displayed high healing rates (88.5%). Double plating of non-unions achieved excellent osseous union rates (98.5%). Conclusions The literature provides evidence for superior outcomes when using double plating in distal femoral fractures, periprosthetic fractures and femoral non-unions. Some evidence suggests that the use of double plating of femoral fractures in polytraumatised patients may be beneficial over other types of fracture fixation. Level of evidence IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Union rates and functional outcome of double plating of the femur: systematic review of the literature

Lodde

Raschke

Stolberg-Stolberg

et al. 2021

Arch Orthop Trauma Surg

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“…Zhibiao Bai et al [17] (180 minutes) and Mohammed A imam et al [18] (213 minutes) our had less operative time.…”

Section: Discussionmentioning

confidence: 70%

A prospective study of functional outcome of comminuted metaphyseal distal femur fracture treated with lateral locking compression plate and medial augmentation with TENS

Chandrashekar¹,

Kjc²,

Sn³

et al. 2021

Int. J. Orthop. Sci.

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Background: Distal femur fractures are complex injuries producing long term disability and present considerable challenges in management. These fractures poses challenges to the treating surgeon because of thin cortex of the femoral condyles, wide medullary canal, relative osteopenia, short condylar fragment and comminution involving articular surface. Distal femur fracture disrupts normal knee joint functioning, hence needed anatomical reduction and stable internal fixation to prevent crippling disabilities and hardware failure. Objective: To evaluate the functional and radiological outcome of comminuted metaphyseal fracture of distal femur treated by Lateral locking compression plate and medial TENS nail using NEER'S score. Methods: In this study, 20 cases of comminuted metaphyseal fracture of distal femur were operated between November 2018 to April 2020 with distal femur lateral locking compression plate and medial augmentation with tens nail. Patients were selected based on inclusion and exclusion criteria and were followed up for 12 months. The results were analysed with NEER'S score. Results: Out of 20 patients with comminuted metaphseal distal femur fractures AO-Muller type A3subtypes 15 and C2 subtypes 5 patients were studied. Mean age of the patients was 45.5 years with age ranging from 20 years to 80 years. Right sided fractures were predominant. In 65% cases mode of injury was road traffic accident and rest were self-fall. 2 cases were operated under MIPPO technique and rest all were operated on with standard open lateral approach. Average surgical procedure timing was 119.5 minutes in our study. Average duration of radiological union was 18.6 weeks and average duration of weight bearing was 20.5 weeks. Complications such as superficial wound infection, knee pain and stiffness were observed in 9 patients. The NEER'S score was excellent in 45%, good-fair in 50% and 5% poor outcome. Conclusion: Comminuted distal femur fracture needs dual column fixation to achieve bone healing and restore function of the affected limb in shortest time without compromising stability. The advantage medial augmentation with TENS is active range of motion can be started earlier, stable internal fixation that does not allow varus collapse, mal-union and further implant failure.

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“…In patients who have been treated by double plating there is an increased risk of need of bone grafting whereas single plating may be associated with less risk of need for subsequent bone grafting. 5 We conducted this study to evaluate the functional outcome of operated cases of comminuted fracture of lower end of femur fixed with locking compression plate laterally and augmented with titanium elastic nail system medially.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of distal femoral fractures managed surgically using locking compression plate laterally and augmented with titanium elastic nail system medially

et al. 2021

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Background: Distal femur fractures are generally due to high velocity trauma particularly form road traffic accidents and fall from height. The treatment of distal femur fractures has evolved from conservative to operative to fixation of both lateral and medial columns of femur. Aims and Objective: The aim of this study was to evaluate the functional outcome of operated cases of comminuted fracture of lower end of femur fixed with locking compression plate laterally and augmented with titanium elastic nail system medially. Materials and Methods: The present study was a prospective study carried out in Bharati Vidyapeeth Medical College and Hospital, Sangli after approval from institutional ethical committee. In this study, 20 patients with communited fracture of lower end of femur were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all cases. After preanesthetic evaluation and relevant investigations patients were treated by reduction (close or open) and fixation was done by locking compression plate laterally and augmented with titanium elastic nail system medially. Patients were followed up at 6, 10 and 14 weeks for functional outcome by Neer’s scoring system and degree of flexion at knee joint. Results: Out of 20 studied cases there were 16 (80%) males and 4 (20%) were females with a M:F ratio of 4:1. The mean age of male patients was found to be 42.81+/-14.79 whereas mean age of female patients was 40.5 +/- 14.36. The mean age of male and female patients was found to be comparable with no statistically significant difference (P=0.78). Most of the patient were diagnosed with the fracture of AO TYPE C3 (7 cases), followed by AO TYPE C1 (4 cases). Full weight bearing was achieved in 8 (40%) patients within 18 weeks whereas remaining 12 (60%) patients required more than 20 weeks for full weight bearing. 14 (70%) patients had excellent outcome whereas, Good, Fair and poor outcomes were seen in 4 (20%), 1 (5%) and 1 (5%) patient. On one-way ANOVA analysis, showed that the flexion was significantly higher in 12 weeks as that of the 6 weeks (P =<0.0001). Further the flexion was significantly higher in 24 weeks as that of the 6 and 12 weeks (P =<0.0001). Conclusion: Our study found that locking compression plating laterally augmented with titanium elastic nail system medially for comminuted distal femoral fractures is a good fixation system and provides good angular stability.

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Comparison of Clinical Efficacy of Lateral and Lateral and Medial Double-plating Fixation of Distal Femoral Fractures

Cited by 17 publications

References 19 publications

Union rates and functional outcome of double plating of the femur: systematic review of the literature

Union rates and functional outcome of double plating of the femur: systematic review of the literature

A prospective study of functional outcome of comminuted metaphyseal distal femur fracture treated with lateral locking compression plate and medial augmentation with TENS

Functional outcome of distal femoral fractures managed surgically using locking compression plate laterally and augmented with titanium elastic nail system medially

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