External Fixator–Assisted Reduction of Distal Femur Fractures: A Technical Trick

Shymon, Stephen; Ulitto, Joseph; Barei, David P.; Sirkin, Michael; Reilly, Mark C.; Adams, Mark

doi:10.1097/bot.0000000000001901

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…External fixator-assisted reduction is a well-known technique in traumatology, several authors reported the use of external fixator to restore anatomical alignment and length before internal fixation. Shymon and co-workers [ 16 ] described a percutaneous technique that sequentially reduces and aligns distal femur fractures with an anterior external fixator before definitive fixation with a lateral distal femoral locking plate. Gopinathan and colleagues [ 3 ] proposed a Fixator Assisted Submuscular plating Technique (FAST), which minimizes the surgical time and simplifies the submuscular plating in pediatric femur fractures.…”

Section: Discussionmentioning

confidence: 99%

External fixator‐assisted plating osteosynthesis in a rabbit model of femoral bone defects appears to be a feasible and reproducible surgical technique: preliminary insights from a bone substitute study

Vandenbulcke,

Anzillotti,

Ravasio

et al. 2023

J. exp. orthop.

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Purpose The aims of this study were to assess the complications associated with the use of an external fixator-assisted plate osteosynthesis technique to stabilize a femoral bone defect in a rabbit model and to evaluate if this technique could avoid the mispositioning and the displacement of the femoral fragments during the surgical procedure. Methods A preliminary cadaveric animal study was conducted to develop a new technique of external fixator-assisted plating. Thirty rabbits underwent a surgical procedure consisting in the creation of a femoral bone defect and, subsequently an implantation of a bone substitute through the assistance of a temporary external fixator. The fixator’s ability to maintain length and alignment during surgery was documented. All intraoperative complications were prospectively collected. Results No complications related to the use of the temporary external fixator were reported. The technique successfully prevented mispositioning and dislocation during plating in all the rabbits. Conclusion In a rabbit animal model, the use of an external fixator-assisted plate osteosynthesis technique appears to be feasible and effective in avoiding misposition and rotation of femoral fragments when performing osteotomy and plating to create a mid-diaphyseal femoral defect.

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Section: Discussionmentioning

confidence: 99%

External fixator‐assisted plating osteosynthesis in a rabbit model of femoral bone defects appears to be a feasible and reproducible surgical technique: preliminary insights from a bone substitute study

Vandenbulcke,

Anzillotti,

Ravasio

et al. 2023

J. exp. orthop.

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Distal femoral fine wire traction assisted retrograde nailing of the femur

Chen

Avedian

Gardner

et al. 2021

Eur J Orthop Surg Traumatol

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Staged Management for Distal Femur Fractures: Impacts on Reoperation, Stiffness, and Overall Outcomes

Yeager,

Rutz,

Roszman

et al. 2024

Journal of Orthopaedic Trauma

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OBJECTIVES: To evaluate the outcomes of staged management with external fixation (ex-fix) prior to definitive fixation of distal femur fractures. METHODS: Design: Retrospective cohort. Setting: Single Level I Trauma Center. Patient Selection Criteria: Adults treated operatively between 2004 and 2019 for distal femur fractures (OTA/AO 33A/33C) were identified using Current Procedural Terminology codes. Excluded cases were those with screw only fixation, acute distal femur replacement, 33B fracture pattern, no radiographs available, or did not have 6-months of follow-up. Outcome Measures and Comparisons: Postoperative complication rates including surgical site infection [SSI], reoperation to promote bone healing, final knee arc of motion <90 degrees, heterotopic ossification formation, and reoperation for stiffness were compared between patients treated with ex-fix prior to definitive fixation and those not requiring ex-fix. RESULTS: A total of 407 patients were included with a mean follow-up of 27 months (median [IQR] of 12 [7,33] months), (range 6-192 months). Most patients were male (52%) with an average age of 48 [Range: 18-92] years. Ex-fix was utilized in 150 (37%) cases and 257 (63%) cases underwent primary definitive fixation. There was no difference in SSI rates (p=0.12), final knee arc of motion <90 degrees (p=0.51), and reoperation for stiffness (p=0.41) between the ex-fix and no ex-fix groups. The 150 patients requiring ex-fix spent an average of 4.2 days (SD 3.3) in the ex-fix before definitive fixation. These patients were further analyzed by comparing the duration of time spent in ex-fix, <4 days (n=82) and ≥4 days (n=68). Despite longer time spent in ex-fix prior to definitive fixation, there was again no significant difference in any of the complication and reoperation rates when comparing the two groups, including final knee arc of motion <90 degrees (p=0.63), reoperation for stiffness (p=1.00), and SSI (p=0.79). CONCLUSION: Ex-fix of distal femur fractures as a means of temporary stabilization prior to definitive ORIF does not increase the risk of complications such as SSI, final knee arc of motion <90 degrees, or reoperations for bone healing or stiffness when compared to single stage ORIF of distal femur fractures. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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External Fixator–Assisted Reduction of Distal Femur Fractures: A Technical Trick

Cited by 3 publications

References 22 publications

External fixator‐assisted plating osteosynthesis in a rabbit model of femoral bone defects appears to be a feasible and reproducible surgical technique: preliminary insights from a bone substitute study

External fixator‐assisted plating osteosynthesis in a rabbit model of femoral bone defects appears to be a feasible and reproducible surgical technique: preliminary insights from a bone substitute study

Distal femoral fine wire traction assisted retrograde nailing of the femur

Staged Management for Distal Femur Fractures: Impacts on Reoperation, Stiffness, and Overall Outcomes

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