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The Management of Aseptic Non-unions of Distal Femur Fractures with Anatomical Lateral Locking Plates

BACKGROUND: Distal femoral non-unions are challenging, and frequently associated with short distal fragments, poor bone stock, and with issues from previous implants. MATERIALS AND METHODS: A retrospective study of 31 patients admitted with distal femoral non-unions treated using anatomical lateral...

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Detalles Bibliográficos
Autores principales: Mukhopadhaya, John, Ranjan, Rajeev, Sinha, Amit Kumar, Bhadani, Janki Sharan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886028/
https://www.ncbi.nlm.nih.gov/pubmed/36756289
http://dx.doi.org/10.5005/jp-journals-10080-1564
Descripción
Sumario:BACKGROUND: Distal femoral non-unions are challenging, and frequently associated with short distal fragments, poor bone stock, and with issues from previous implants. MATERIALS AND METHODS: A retrospective study of 31 patients admitted with distal femoral non-unions treated using anatomical lateral locking plates. Non-union scores were used. The Knee Society and Neer's scores were used for the comparison of results. The mean follow-up was 39.5 months (from 24 months to 60 months). RESULTS: Stable union was accomplished in all. There was a significant improvement in the average Neer's score (24 preoperative to 82 post-operatively at final follow-up), the Part 1 Knee Society score from an average of 46 preoperatively to 84 post-operatively, and Part 2 Knee Society score from 36 preoperatively to 80 post-operatively. CONCLUSION: Optimal stability, good compression at the non-union site (either by lag screws or a compression device or both), maintaining the axial alignment strictly, freshening of bone ends, using an adequate amount of cortico-cancellous bone graft, respecting the biology along with the correct choice of the implant (including the size) are essential to achieve union at the fracture site. CLINICAL SIGNIFICANCE: Paying attention to the basic principles of management, good contact, stability and maintaining biology is essential in the treatment of non-union. HOW TO CITE THIS ARTICLE: Mukhopadhaya J, Ranjan R, Sinha AK, et al. The Management of Aseptic Non-unions of Distal Femur Fractures with Anatomical Lateral Locking Plates. Strategies Trauma Limb Reconstr 2022;17(3):137–143.