Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort

被引：23

作者：

Kiyono, Masahiro ^{[1
]}

Noda, Tomoyuki ^{[2
]}

Nagano, Hiroshi ^{[3
]}

Maehara, Takashi ^{[4
]}

Yamakawa, Yasuaki ^{[5
]}

Mochizuki, Yusuke ^{[1
]}

Uchino, Takahiko ^{[1
]}

Yokoo, Suguru ^{[1
]}

Demiya, Koji ^{[1
]}

Saiga, Kenta ^{[1
]}

Shimamura, Yasunori ^{[1
]}

Ozaki, Toshifumi ^{[1
]}

机构：

[1] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Orthoped Surg, Kita Ku, 2-5-1 Shikata Cho, Okayama, Okayama 7008558, Japan

[2] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Musculoskeletal Traumatol, 2-5-1 Shikata Cho, Okayama, Okayama 7008558, Japan

[3] Kagawa Prefectural Cent Hosp, Dept Orthoped Surg, 1-2-1 Asahi Machi, Takamatsu, Kagawa 7608557, Japan

[4] Kagawa Rosai Hosp, Dept Orthoped Surg, Jotocho, Marugame, Kagawa 7638502, Japan

[5] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Community & Emergency Med, Kita Ku, 2-5-1 Shikata Cho, Okayama, Okayama 7008558, Japan

来源：

JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH | 2019年 / 14卷 / 01期

关键词：

Distal femur fracture; Relative stability; Bridging plate; Locking compression plate; Empty hole; INVASIVE STABILIZATION SYSTEM; FEMUR FRACTURES; FIXATION; LISS; CLASSIFICATION; EPIDEMIOLOGY; STABILITY; STIFFNESS; FAILURE; LCP;

D O I：

10.1186/s13018-019-1401-9

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: Plate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method. Methods: This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them. Results: Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes. Conclusions: We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.

引用

页数：9

共 31 条

[11] Choosing a proper working length can improve the lifespan of locked plates A biomechanical study [J].