Distale Femurfrakturen

Bliemel, Christopher; Bücking, Benjamin; Ruchholtz, Steffen

doi:10.1055/s-0042-111298

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…In our study, we aimed to expand on the results of He et al by examining cortical thickness in a large cohort of patients with DFF and correlate the data with clinical parameters of bone quality. Moreover, as the preoperative work-up in the majority of patients with distal femur fractures includes a CT scan to assess intraarticular involvement, our second objective was to develop a method to determine cortical thickness in these scans [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

Huppke,

Fahlbusch,

Frosch

et al. 2023

Arch Orthop Trauma Surg

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Aim Distal femur fractures (DFF) are rare, but associated with high complication rates and mortality, particularly in patients with osteoporosis. To improve preoperative assessment, we analyzed if cortical bone thickness on CT and AP radiographs is associated with clinical parameters of bone quality. Methods Retrospective single-center study of adult patients presenting at a level-one trauma center, with a DFF between 2011 and 2020. Clinical parameters for bone quality, such as age, sex, body mass index (BMI), energy impact level of trauma, and known history of osteoporosis, were assessed. Mean cortical bone thickness (CBTavg) on AP radiograph was determined using a previously published method. Cortical thickness on CT scan was measured at 8 and 14 cm proximal to the articular surface of the lateral condyle. Results 71 patients (46 females) between 20 and 100 years were included in the study. Cortical thickness determined by CT correlated significantly with CBTavg measurements on AP radiograph (Spearman r = 0.62 to 0.80; p < 0.001). Cortical thickness was inversely correlated with age (Spearman r = − 0.341 to − 0.466; p < 0.001) and significantly associated with trauma impact level and history of osteoporosis (p = < 0.001). The CT-based values showed a stronger correlation with the clinical parameters than those determined by AP X-ray. Conclusion Our results showed that cortical thickness of the distal femur correlates with clinical parameters of bone quality and is therefore an excellent tool for assessing what surgical care should be provided. Interestingly, our findings indicate that cortical thickness on CT is more strongly correlated with clinical data than AP radiograph measurements.

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Section: Introductionmentioning

confidence: 99%

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

Huppke,

Fahlbusch,

Frosch

et al. 2023

Arch Orthop Trauma Surg

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“…In this context, in addition to a polyaxially angular stabile plate, the prior use of a wire cerclage for an initial anatomical reduction of extra-articular two-part spiral or oblique distal femoral fractures has been shown to be beneficial [ 5 , 6 ] (Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

More than a reposition tool: additional wire cerclage leads to increased load to failure in plate osteosynthesis for supracondylar femoral shaft fractures

Bliemel

Anrich

Knauf

et al. 2020

Arch Orthop Trauma Surg

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Introduction Surgical treatment of supracondylar femoral fractures can be challenging. An additional wire cerclage is a suggested way to facilitate fracture reduction prior to plate osteosynthesis. Denudation to the periosteum remains a problematic disadvantage of this procedure. This study analyzed the effect of an additional wire cerclage on the load to failure in plate osteosynthesis of oblique supracondylar femoral shaft fractures. Materials and methods On eight pairs of non-osteoporotic human femora (mean age 74 years; range 57-95 years), an unstable AO/OTA 32-A2.3 fracture was established. All specimens were treated with a polyaxially locking plate. One femur of each pair was randomly selected to receive an additional fracture fixation with a wire cerclage. A servohydraulic testing machine was used to perform an incremental cyclic axial load with a load to the failure mode. Results Specimens stabilized with solely plate osteosynthesis failed at a mean load of 2450 N (95% CI: 1996-2904 N). In the group with an additional wire cerclage, load to failure was at a mean of 3100 N (95% CI: 2662-3538 N) (p = 0.018). Compression deformation with shearing of the condyle region through cutting of screws out of the condylar bone was the most common reason for failure in both groups of specimens. Whereas axial stiffness was comparable between both groups (p = 0.208), plastic deformation of the osteosynthesis constructs differed significantly (p = 0.035). Conclusions An additional wire cerclage significantly increased the load to failure. Therefore, an additional cerclage represents more than just a repositioning aid. With appropriate fracture morphology, a cerclage can significantly improve the strength of the osteosynthesis.

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Long Bone Fractures

Schindler

Marzi

2023

Acute Care Surgery in Geriatric Patients

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Distale Femurfrakturen

Cited by 4 publications

References 4 publications

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

More than a reposition tool: additional wire cerclage leads to increased load to failure in plate osteosynthesis for supracondylar femoral shaft fractures

Long Bone Fractures

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