Double plating versus nail-plate construct in AO 33C distal femur fractures: treatment choice affects knee alignment, clinical outcomes, and quality of life-a multicenter study

被引：2

作者：

De Mauro, Domenico ^{[1
,2
,3
]}

Smakaj, Amarildo ^{[2
,4
]}

Casiraghi, Alessandro ^{[5
]}

Galante, Claudio ^{[5
]}

Bove, Federico ^{[6
]}

Arduini, Mario ^{[7
]}

Vicenti, Giovanni ^{[8
,9
]}

Addevico, Francesco ^{[6
]}

Fratus, Abramo ^{[5
]}

Macellari, Nicola ^{[2
]}

Caredda, Matteo ^{[2
,7
]}

Buono, Claudio ^{[8
,9
]}

Maccauro, Giulio ^{[1
,2
]}

Rovere, Giuseppe ^{[2
,10
]}

Liuzza, Francesco ^{[1
,2
]}

机构：

[1] Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Orthoped Ageing & Rheumatol Sci, I-00168 Rome, Italy

[2] Univ Cattolica Sacro Cuore, Dept Orthoped & Geriatr Sci, Largo Francesco Vito 8, I-00168 Rome, Italy

[3] Univ Naples Federico II, Dept Publ Hlth, Orthoped Unit, I-80131 Naples, Italy

[4] Tor Vergata Univ, Dept Biomed & Prevent, Orthoped Unit, I-00133 Rome, Italy

[5] ASST Spedali Civili, Orthoped & Traumatol Unit, I-25123 Brescia, Italy

[6] ASST Grande Osped Metropolitano Niguarda, Orthoped & Traumatol Unit, I-20162 Milan, Italy

[7] Osped St Eugenio, Orthoped & Traumatol Unit, I-00144 Rome, Italy

[8] Aldo Moro Univ, Sch Med, Dept Basic Med Sci Neurosci & Sense Organs, I-70121 Bari, Italy

[9] Azienda Osped Univ Consorziale Policlin Giovanni X, Orthoped & Traumatol Unit, I-70124 Bari, Italy

[10] Tor Vergata Univ, Dept Clin Sci & Translat Med, Orthoped & Traumatol Unit, I-00133 Rome, Italy

来源：

JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY | 2025年 / 26卷 / 01期

关键词：

Distal femur fractures; Double plates; Plate and nail; Knee fractures; Complications; FEMORAL FRACTURES; FIXATION; EPIDEMIOLOGY; COMBINATION; SYSTEM;

D O I：

10.1186/s10195-025-00834-1

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Distal femur fractures present a significant challenge for orthopedic surgeons, accounting for approximately 5% of all femoral fractures. Among the most commonly reported combined techniques in the literature are the double-plate technique and the retrograde nailing plus lateral plating, the nail-plate construct (NPC). The aim of our study is to compare surgical data, quality of life, and functional outcomes in 33-C fractures treated with either double-plate constructs or a retrograde nailing plus lateral plate. Materials and methods: A multicenter retrospective observational study was conducted in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Diagnoses were made on the basis of the AO classification, utilizing traditional radiological assessments. Patients were categorized into two groups on the basis of the surgical treatment they received: The NPC group comprised patients who underwent surgery with nail-plate construct, while the Plate group consisted of those who had surgery with double plating. Results: A total of 42 patients were included in the study. The NPC group comprised 26 patients with a mean age of 58.4 +/- 18.8 years, while the Plate group consisted of 16 patients with a mean age of 61.3 +/- 16.4 years. Significant differences were observed in knee extension recovery (p = 0.010) and lateral distal femur angle (LDFA) (p < 0.001). Linear regression showed a significant influence from treatment choice on all the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, as well as in all domains of the European Quality of Life Five Dimensions Five-Level Version (EQ-5D-5L), except for the Daily Self-Care domain. Conclusions: Nail-plate constructs seems to lead to significantly better outcomes in AO type C distal femur fractures, compared with double plating, in terms of knee function and quality of life. Significant differences are shown also in anatomical outcomes, especially in extension gap, and LDFA.

引用

页数：10

共 31 条

[1] Interventions for treating fractures of the distal femur in adults [J].