Internal fixators: a safe option for managing distal femur fractures?

Batista, Bruno Bellaguarda; Salim, Rodrigo; Paccola, Cleber Antônio Jansen; Kfuri, Maurício

doi:10.1590/1413-78522014220300509

Cited by 11 publications

(11 citation statements)

References 18 publications

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“…We found this problem in one of the femurs presented at Figure 2. Batista et al [3] reported 27% failure rate in the initial reduction with axis deviation and linked this problem to the difficulty in adapting an implant sized to a population ethnically very distinct from theirs.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] Fitting the plate in the correct position while completion of alignment in all three axes can be cumbersome even to the experienced surgeons, and technical errors are not forgiving. [3] Reduction without using the plate is particularly challenging when performing minimally invasive surgery since bone exposure is very limited. [4] It requires various traction procedures, various percutaneous reduction clamps, K-wires to manipulate the bone fragments and provisional pinning.…”

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confidence: 99%

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Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones

Utkan

İğdir

Arslan

et al. 2019

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada iki anatomik distal femur plağının kadavra femurlarıyla uyumluluğu araştırıldı ve mevcut plakların her femura en iyi şekilde uyup uymadığı gösterildi. Gereç ve yöntemler: Gövdesinde beş, yedi ve dokuz deliği olan iki farklı plak seti 62 kadavra femuruna uygulandı. Plakların tüm iç yüzeyleri seramik çamuruyla sıvandı, sonra plaklar iki adet kendinden kilitli naylon kablo bağı kullanılarak kemiklere sabitlendi. Plak ve kemik arasında sıkıştırılan seramik çamurunun hacmi hesaplanarak nicel uyum parametresi olarak kullanıldı. Her plağın verileri ayrı ayrı analiz edildi. Bulgular: Double Medical Technology Incorporated TM plakları kullanıldığında, plak ile kemik arasındaki hacim ortalamaları beş, yedi ve dokuz delikli plaklarda sırasıyla 8.4 mL (dağılım, 5-14 mL), 10.0 mL (dağılım, 6-17 mL) ve 13.1 mL (dağılım, 7-25 mL) olarak hesaplandı. Zimmer Biomet Incorporated TM plakları kullanıldığında, hacim ortalamaları beş, yedi ve dokuz delikli plaklarda sırasıyla 10.5 mL (dağılım, 6-21 mL), 12.7 mL (dağılım, 7-22 mL) ve 16.3 mL (dağılım, 8-30 mL) idi. Her grup içinde, ölçümler femur uzunluğu ile pozitif olarak anlamlı şekilde bağıntılı idi. Sonuç: Mevcut distal femur plağı implant setleri kullanılarak her femurda en iyi uyum elde edilemeyebilir. Bu nedenle, implant setlerinde ilave boyutlarda plaklar sağlanmalıdır.Anahtar sözcükler: Kadavra kuru femur kemiği, kilitli plakların uygunluğu, distal femur plağı, uyum değerlendirme parametresi, plak kemik uyumu; önceden şekillendirilmiş plak uyumu, nicel uyum parametresi. ABSTRACTObjectives: This study aims to investigate the fitness of two anatomic distal femoral plates with cadaveric femurs and to show whether current plates optimally match each femur. Materials and methods: Two different sets of plates with five, seven and nine shaft holes were applicated on 62 cadaveric femurs. Ball clay was molded onto the entire inner surfaces of the plates and then the plates were fixed to the bones using two self-locking nylon cable zip ties. The volume of ball clay sandwiched in between the plate and bone was calculated and used as a quantitative fit parameter. Data of each plate were analyzed separately. Results: Using Double Medical Technology Incorporated TM plates, the mean plate to bone volumes were calculated as 8.4 mL (range, 5-14 mL), 10.0 mL (range, 6-17 mL), and 13.1 mL (range, 7-25 mL) in five, seven and nine-hole plates, respectively. Using Zimmer Biomet Incorporated TM plates, the mean volumes were 10.5 mL (range, 6-21 mL), 12.7 mL (range, 7-22 mL) and 16.3 mL (range, 8-30 mL) in five, seven and nine-hole plates, respectively. Within each group, the measurements were significantly correlated positively with femoral length. Conclusion: Optimal fit may not be achieved in each femur using current distal femoral plate implant sets. Thus additional sizes of plates should be supplied in the implant sets.Keywords: Cadaveric dry femur bone, congruency of locking plates, distal femur plate, fit assessment parameter, plate bone fit, precontoured plate fit, quanti...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones

Utkan

İğdir

Arslan

et al. 2019

Eklem Hastalik Cerrahisi

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“…Most of these implants require C-arm fluoroscopy during opera ve period of fixa on. Newly introduced distal femoral locking compression plate (DF-LCP) is precontoured, which provides angular stability and rigid [3][4][5] fixa on. Objec ve of our study is to analyses the func onal outcomes of ORIF with DF-LCP in distal femur fractures.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Surgical Management of Distal Femur Fracture with Distal Femoral Locking Compression Plate at Koshi Zonal Hospital

Sah¹,

Karn

et al. 2018

Birat J. Health Sci.

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Introduction: Distal femoral fractures comprise 4-6% of all femur fractures. The management of distal femur fractures are challenging because of significant morbidity and complication rate even with advanced surgical techniques and implants. Open reduction and internal fixation (ORIF) with pre-contoured distal femoral locking compression plate (DF-LCP) is one of the most acceptable surgical procedures these days.Objectiv: Evaluation of functional outcomes of distal femur fractures managed surgically using DF-LCP at Koshi Zonal Hospital.Methodology: In this cross sectional study 21 patients having closed distal femur fractures with or without intra-articular extension to femoral condyle fixed with DF-LCP at Koshi Zonal Hospital, Nepal from March 2016 to March 2017 were included. Patients with open fracture, severe comminuted fracture, and neurovascular impairment were excluded. These patients were followed-up for up to one year and we recorded the knee range of motion, full weight bearing time fracture union time, and complications. We used Neers' functional scoring system to evaluate the final outcomes and data was analysed using Microsoft Excel Programe.Results: Out of the 21 patients of distal femur fractures, 16 were diametaphyseal distal femur fractures and five were supracondylar fractures with intra-articular extension. Mean age recorded was 45 (range 19-75) years, hospital stay mean duration 12 (range 10-19) days and duration of surgery 85 (range 60-150) minutes, full weight bearing walking time mean 16 (range 12-22) weeks, radiological union time mean 20 (range 17-29) weeks and Neers' score was excellent in 66.66%, satisfactory in 23.80%, unsatisfactory in 4.76%, and poor in 4.76%.None of our patients had complications like; loss of fixation, implant failure or post-operative neurovascular injury.Conclusion: Distal Femoral Locking Plate is one of the best implant to be used as fixation method for both extra-articular and intraarticular distal femur fracture.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 260-265

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“…As a result of population ageing and rising of the number of accidents, the incidence of femur fractures, especially AO/OTA (Arbeitsgemeinschaft f€ ur Osteosynthesefragen/ the Orthopaedic Trauma Association) 33 type distal fractures, is increasing. [1,2] These lesions have a bimodal distribution affecting both elderly female patients with osteoporotic bones and young male patients with high-energy traumas.…”

Section: Introductionmentioning

confidence: 99%

“…[6,7] Most important of all, pre-contoured anatomic plates, according to femur anatomy, contribute to the reconstruction of complex surfaces, especially in knee joints. [2] Generally, femur plates are designed and fabricated in a serialized way, according to race, sex, height, etc. [8] For individual differences of bone morphology and fractures, even if plates are subdivided well enough, there are still many cases in which the selected plates from existing serializations could not match the femur surface.…”

Section: Introductionmentioning

confidence: 99%

A parametric approach to construct femur models and their fixation plates

Chen

et al. 2016

Biotechnology & Biotechnological Equipment

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Although anatomic plates reflect an important breakthrough in the treatment of distal femur fractures, there are still some patients experiencing healing complications. For individual differences in bone morphology and fractures, the development of patient specific plates is very complex and needs a long cycle. In this study, a parametric approach was proposed to conveniently construct femur models and design their fixation plates. First, the typical femur anatomy was described with the average femur model. Second, five surface features were defined to represent the femur surface model by setting up parameterization and parameter constraints. Third, according to the fracture information of a specific patient, customized plate surface with a suitable contour was created from the reconstructed femur model. Finally, the femur plate was represented by feature parameterization, and the hierarchical constraints between femur parameters and plate parameters were built to construct a plate model. The experimental results showed that the proposed method could effectively represent femur surface shape features and intuitively construct and edit individualized plates with high-level parameters. The method is competitive in time saving and design convenience and may provide a basic tool for digital restoration of incomplete femurs and the design of patient specific femur plates.

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Internal fixators: a safe option for managing distal femur fractures?

Cited by 11 publications

References 18 publications

Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones

Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones

Outcomes of Surgical Management of Distal Femur Fracture with Distal Femoral Locking Compression Plate at Koshi Zonal Hospital

A parametric approach to construct femur models and their fixation plates

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