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The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur
INTRODUCTION: Varus collapse followed by osteosynthesis for distal femoral fractures with conventional implants has been well documented but is seldom mentioned in fractures managed with locking plates. The purpose of this study was to assess the incidence of varus collapse after treating complex su...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10491700/ https://www.ncbi.nlm.nih.gov/pubmed/37347253 http://dx.doi.org/10.1007/s00402-023-04953-4 |
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author | Liu, Chang-Heng Tsai, Ping-Jui Chen, I-Jung Yu, Yi-Hsun Chou, Ying-Chao Hsu, Yung-Heng |
author_facet | Liu, Chang-Heng Tsai, Ping-Jui Chen, I-Jung Yu, Yi-Hsun Chou, Ying-Chao Hsu, Yung-Heng |
author_sort | Liu, Chang-Heng |
collection | PubMed |
description | INTRODUCTION: Varus collapse followed by osteosynthesis for distal femoral fractures with conventional implants has been well documented but is seldom mentioned in fractures managed with locking plates. The purpose of this study was to assess the incidence of varus collapse after treating complex supra-intercondylar fractures of the distal femur (AO type C3) using a Single Plate (SP) or Double Plate (DP) fixation technique. MATERIALS AND METHODS: We retrospectively reviewed 357 patients with distal femoral fractures who were treated at our hospital between 2006 and 2017. After excluding cases of infection, malignancy, periprosthetic fracture, revision surgery, pediatric fracture, and extra-articular fracture, 54 patients were included in the study. All demographic data and radiological and clinical outcomes were reviewed and analyzed. RESULTS: There were 54 patients enrolled into this study with age from 15 to 85 years old (mean 41.6, SD = 19.9), and 32 of them were open fractures (59%). The patients were further divided into either an SP (n = 15) or a DP group (n = 39). Demographics, including age, sex, injury severity score, and open fracture type, were all compatible between the two groups. The overall nonunion rate was 25.9% (n = 14; 6 from the SP and 8 from the DP group; p = 0.175). The varus collapse rate was 9.3% (n = 5; 4 from the SP and 1 from the DP group (p = 0.018). CONCLUSIONS: The varus collapse rate after osteosynthesis with a single lateral locking plate could be as high as 26.7% in AO type C3 fractures of the distal femur, which would be decreased to 2.6% by adding a medial buttress plate. Surgeons should consider DP fixation to avoid varus collapse in severely comminuted complete intra-articular fractures of the distal femur. |
format | Online Article Text |
id | pubmed-10491700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-104917002023-09-10 The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur Liu, Chang-Heng Tsai, Ping-Jui Chen, I-Jung Yu, Yi-Hsun Chou, Ying-Chao Hsu, Yung-Heng Arch Orthop Trauma Surg Trauma Surgery INTRODUCTION: Varus collapse followed by osteosynthesis for distal femoral fractures with conventional implants has been well documented but is seldom mentioned in fractures managed with locking plates. The purpose of this study was to assess the incidence of varus collapse after treating complex supra-intercondylar fractures of the distal femur (AO type C3) using a Single Plate (SP) or Double Plate (DP) fixation technique. MATERIALS AND METHODS: We retrospectively reviewed 357 patients with distal femoral fractures who were treated at our hospital between 2006 and 2017. After excluding cases of infection, malignancy, periprosthetic fracture, revision surgery, pediatric fracture, and extra-articular fracture, 54 patients were included in the study. All demographic data and radiological and clinical outcomes were reviewed and analyzed. RESULTS: There were 54 patients enrolled into this study with age from 15 to 85 years old (mean 41.6, SD = 19.9), and 32 of them were open fractures (59%). The patients were further divided into either an SP (n = 15) or a DP group (n = 39). Demographics, including age, sex, injury severity score, and open fracture type, were all compatible between the two groups. The overall nonunion rate was 25.9% (n = 14; 6 from the SP and 8 from the DP group; p = 0.175). The varus collapse rate was 9.3% (n = 5; 4 from the SP and 1 from the DP group (p = 0.018). CONCLUSIONS: The varus collapse rate after osteosynthesis with a single lateral locking plate could be as high as 26.7% in AO type C3 fractures of the distal femur, which would be decreased to 2.6% by adding a medial buttress plate. Surgeons should consider DP fixation to avoid varus collapse in severely comminuted complete intra-articular fractures of the distal femur. Springer Berlin Heidelberg 2023-06-22 2023 /pmc/articles/PMC10491700/ /pubmed/37347253 http://dx.doi.org/10.1007/s00402-023-04953-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Trauma Surgery Liu, Chang-Heng Tsai, Ping-Jui Chen, I-Jung Yu, Yi-Hsun Chou, Ying-Chao Hsu, Yung-Heng The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title | The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title_full | The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title_fullStr | The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title_full_unstemmed | The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title_short | The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur |
title_sort | double-plate fixation technique prevents varus collapse in ao type c3 supra-intercondylar fracture of the distal femur |
topic | Trauma Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10491700/ https://www.ncbi.nlm.nih.gov/pubmed/37347253 http://dx.doi.org/10.1007/s00402-023-04953-4 |
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