Issue |
SICOT-J
Volume 10, 2024
|
|
---|---|---|
Article Number | 20 | |
Number of page(s) | 8 | |
Section | Lower Limb | |
DOI | https://doi.org/10.1051/sicotj/2024016 | |
Published online | 30 May 2024 |
Original Article
The linked nail/plate construct for the management of distal femur fractures in the elderly
Department of Trauma and Orthopaedics, Bedfordshire NHS Foundation Trust, Bedford Hospital, South Wing, Kempston Road, Bedford MK429DJ, United Kingdom
* Corresponding author: georgesaraglis@icloud.com
Received:
3
March
2024
Accepted:
23
April
2024
Background: Distal femoral fractures represent a challenging injury, with many different factors such as the method of fixation, complexity of fracture pattern, and patient co-morbidities affecting the outcome. Lots of surgical treatment options have been described, but recently double construct fixation, using a nail/plate combination, has received lots of attention, a technique that leads to faster weight-bearing, low risk of metalwork failure, and non-union. The purpose of this study was to investigate the effectiveness of the linked nail/plate construct in the management of complex distal femur fractures and to investigate if the above technique leads to faster recovery and earlier radiographic union. Materials and methods: In total 15 cases were included in the study, that underwent a combined nail/plate construct for a distal femur fracture between January 2021 and December 2022. Only cases with a linked nail/plate construct were included, with a minimum follow-up of 1 year. Open femur fractures, single implant fixation cases, and revision procedures were excluded. Results: In this cohort study, 11 cases were periprosthetic distal femur features, and 4 cases were distal femur fractures around a native knee joint. The mean age group was 74 years, 86.6% of the patients had a BMI > 25 and the mean time to fracture union was 24 weeks (range from 20 to 26 weeks). All cases healed uneventfully and the complication rate was 6.6%, including 1 case of superficial infection which resolved completely with oral antibiotics. Conclusion: The increasing age population, the complexity of distal femoral fractures along with the increasing physiological demands of the elderly population, drive the need for double fixation constructs that allow early mobilization and enhance fracture stability. In our study, the linked nail/plate construct seems to provide adequate stability and excellent union rates (100%) with no associated increased risk of complications.
Key words: Distal femur fractures / Nail/plate fixation / Double fixation / Augmented fixation
© The Authors, published by EDP Sciences, 2024
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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