0
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      Authors - did you know SICOT-J has been awarded the DOAJ Seal for "best practice in open access publishing"?

      • Indexed in Scopus
      • 30% discount on article processing charges (APCs) for members of SICOT

      Instructions for authors, online submissions and free e-mail alerts all available here 

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The linked nail/plate construct for the management of distal femur fractures in the elderly

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          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.

          Related collections

          Most cited references25

          • Record: found
          • Abstract: found
          • Article: not found

          Locking plates for distal femur fractures: is there a problem with fracture healing?

          Fractures of the distal femur are severe injuries that present many clinical challenges. Nonunion, delayed union, implant failure, and the need for secondary procedures can reflect complications of healing. This article reviews the literature on distal femur fractures treated with locking plates to determine the reported rate of healing difficulties. The PubMed database and the Orthopaedic Trauma Association and American Academy of Orthopedic Surgeons abstract archives were searched for studies including the key words distal femur fracture, supracondylar femur fracture, or locking plate from the year 2000 to the present. Reports were included when distal femur fractures were treated with locking plates and when the number of healed fractures was identified in the study. The reported healing rates and the rate of healing complications were determined from the studies. The time to implant failure was recorded. Those articles that included periprosthetic fractures were separated from those only including acute distal femur fractures. Fifteen full-length publications and three abstracts were included. The rate of complications related to healing ranged from 0% to 32% in these studies. Implant failures occurred late with 75% of the failures occurring after 3 months and 50% occurring after 6 months. Complications of healing including nonunion, delayed union, and implant failure are not infrequent and represent ongoing problems with distal femur fracture treatment. Further clinical research combined with innovation in surgical techniques and implant design will be necessary to improve the results of the last decade.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Distal femoral fractures

            Hip fracture care has evolved, largely due to standardisation of practice, measurement of outcomes and the introduction of the Best Practice Tariff, leading to the sustained improvements documented by the National Hip Fracture Database (NHFD). The treatment of distal femoral fractures in this population has not had the same emphasis. This study defines the epidemiology, current practice and outcomes of distal femoral fractures in four English centres.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Nail Plate Combination Technique for Native and Periprosthetic Distal Femur Fractures.

              In the elderly, low-energy distal femur fractures (native or periprosthetic) can be devastating injuries, carrying high rates of morbidity and mortality, comparable with the hip fracture population. Poor, osteoporotic bone quality facilitates fracture in a vulnerable anatomical region, and as a result, operative fixation can be challenging. With goals of early mobilization to reduce subsequent complication risk, using the nail plate combination technique can offer stable, balanced fixation allowing for immediate weight bearing and early mobilization. We outline the rationale, technical steps, and early clinical outcomes after nail plate combination in the treatment of osteoporotic distal femur (native or periprosthetic) fractures.
                Bookmark

                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2024
                30 May 2024
                : 10
                : 20
                Affiliations
                Department of Trauma and Orthopaedics, Bedfordshire NHS Foundation Trust, Bedford Hospital South Wing, Kempston Road Bedford MK429DJ United Kingdom
                Author notes
                [* ]Corresponding author: georgesaraglis@ 123456icloud.com
                Author information
                http://orcid.org/0000-0001-5916-9183
                Article
                sicotj240021 10.1051/sicotj/2024016
                10.1051/sicotj/2024016
                11141519
                38819290
                3e231bb3-3b18-4678-9245-3b5d787ee990
                © 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.

                History
                : 03 March 2024
                : 23 April 2024
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 22, Pages: 8
                Categories
                Original Article
                Lower Limb

                distal femur fractures,nail/plate fixation,double fixation,augmented fixation

                Comments

                Comment on this article