Double-plating fixation of comminuted femoral shaft fractures with concomitant thoracic trauma

Cheng, Tao; Xia, Ronggang; Yan, Xiaoyu; Luo, Congfeng

doi:10.1177/0300060517720317

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…One study examined outcomes of double plating of femoral shaft fractures [ 8 ]. A second study compared outcomes of double plating versus IM [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, a significantly shorter surgery time and a significantly reduced risk for malunion was observed [ 28 ]. All 141 cases were polytraumatised patients [ 8 ] or patients with an Injury Severity Score (ISS) ≥ 18 [ 28 ]. The overall complication rate was 35% among the 141 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Particularly in polytraumatised patients, plate fixation of the femoral shaft can provide a successful treatment option [ 7 ]. Plate fixation is recommended in patients with lung injuries unsuitable for IM [ 7 , 8 ].…”

Section: Introductionmentioning

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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“…One study examined outcomes of double plating of femoral shaft fractures [ 8 ]. A second study compared outcomes of double plating versus IM [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…While comparing conventional to locking dual plating constructs, Jazrawi et al noted that the latter model was associated with higher stiffness in bending testing in the surgical reduction of distal femoral fractures [27]. A recent study documented good functional outcomes in 14 (93%) of 15 patients who presented with femoral diaphyseal fracture and chest injury and underwent the orthogonal dual plating fixation technique [38]. However, these studies did not compare the biomechanical properties of the adjacent versus orthogonal dual plate configurations, an important variable to account for in the patient's evaluation and management [39].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

Beaino

Lindsey

Gugala

2019

BioMed Research International

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Aim. This study aimed at comparing the mechanical properties of conventional and locking dual plates in adjacent and orthogonal orientations for the surgical fixation of transverse femoral shaft fractures. It also assessed the failure mechanics after dual adjacent and orthogonal locking plate removal. Methods. Thirty-two composite femurs were transversally osteotomized and randomly assigned for fixation with either dual locking or compression plates in an adjacent or orthogonal configuration. Sixteen specimens were preloaded axially to 20 N and single-leg stance loads were simulated. The remaining sixteen constructs were subjected to torsional loads of 10 Nm at a rate of 10 Nm/s in external and internal rotation of the femoral head in relation to the knee. Overall combined rotational stiffness was calculated. Eight different specimens with no osteotomy underwent the same experiments after dual locked plate removal and were tested to failure in combined eccentric axial and torsional modes. Data were statistically processed using a two-tailed t-test and one-way analysis of variance for the comparison of means between two or more groups, respectively. Results. Orthogonal constructs were statistically stiffer in axial loading compared to their adjacent counterparts in both conventional and locking configurations (p<0.001). Dual locking plates provided higher torsional stiffness than conventional ones within each plate orientation (p<0.01). Neither axial/torsional strength nor failure loads differed between constructs that had adjacent or orthogonal dual locking plates instrumented and then removed (p>0.05). Conclusions. In both orthogonal and adjacent orientations, double locking plates provide higher stability than their dual conventional counterparts. Orthogonal dual plate configuration is more stable and biomechanically superior to dual adjacent plating for constructs fixed with either standard compression or locking plates.

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“…Orthopedic implants applied in multiple planes are used in challenging scenarios, such as, for example, patients who are considerably heavy or robust, large animals, wild animals, and in metaphyseal or epiphyseal fractures with fragments that are too small [19, 20]. The main advantages of this configuration are correlated with increases in the area moment of inertia and the consequent marked expansion of the system’s mechanical resistance, in addition to the potential capacity for fixing fragments to bone extremities with limited area for fixation [21, 22]. Multiplanar external skeletal fixators and double or triple plates are commonly used for these purposes, with excellent results [23].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a novel orthogonal angle-stable interlocking nail in a canine femur model Novel orthogonal angle-stable interlocking nail

Lucena

Minto

Rocha

et al. 2021

Preprint

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Interlockings nails (IN) are orthopedic implants with superior mechanical and, potentially, biological qualities. Despite the countless and indisputable advantages of current angle-stable models, there are still limitations for their use in certain scenarios. The objective of the present study was to describe and biomechanically test a new orthogonal angle-stable intramedullary nail model for veterinary use. The proposed orthogonal angle-stable nail has two 3.8-mm threaded cylindrical holes in each of its portions: in the proximal portion, the holes are 11 mm apart; in the distal portion, the penultimate orifice is positioned at 90 degrees in relation to the last one, with a distance of 5.5 mm between them. The novel orthogonal nail (Group 3 – G3) was evaluated and compared biomechanically with the conventional interlocking nail (Group 1 – G1) and the uniplanar angle-stable nail (Group 2 – G2) by means of destructive torsion and axial compression tests. No statistically significant differences were observed in torsion resistance between the groups in the destructive tests. However, statistical differences were found in stiffness values in the compression tests between the orthogonal (G3) and conventional interlocking (G1) nails (p=0.01) and also between the uniplanar (G2) and interlocking (G1) nails (p=0.001). The new orthogonal nail proved to be biomechanically similar to the uniplanar angle-stable model and superior to the conventional nail . This new arrangement of interlocking screws (orthogonal and closer to each other) potentially enables the fixation of small fragments and at the extremities of long bones in dogs. Nonetheless, further clinical studies are necessary to validate such hypotheses.

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Double-plating fixation of comminuted femoral shaft fractures with concomitant thoracic trauma

Cited by 8 publications

References 21 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

Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

Biomechanical evaluation of a novel orthogonal angle-stable interlocking nail in a canine femur model Novel orthogonal angle-stable interlocking nail

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