Early Mechanical Failures of the Synthes Variable Angle Locking Distal Femur Plate

Tank, Jason C.; Schneider, Prism; Davis, Elizabeth; Galpin, Matthew; Prasarn, Mark L.; Choo, Andrew M.; Munz, John W.; Achor, Timothy S.; Kellam, James F; Gary, Joshua L.

doi:10.1097/bot.0000000000000391

Cited by 69 publications

(48 citation statements)

References 18 publications

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“…Other authors described rates of implant failures of up to 16% (11/67) with distal femur plating. 17 The current literature offers diverging advice ranging from weight-bearing restrictions after surgery for 8 to 12 weeks 17-19 to immediate full weight-bearing. 13,14 Poole et al 13 examined 127 patients treated with locking plate osteosynthesis of distal femur fractures who were all allowed immediate full weight-bearing after surgery and found no increase in implant failure or other adverse events.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Distal Femur Fractures in Geriatric Patients

Loosen

Fritz

Dietrich

2019

Geriatr Orthop Surg Rehabil

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Introduction: The treatment of distal femur fractures in geriatric patients is challenging and has a high perioperative morbidity and mortality. Treatments have evolved significantly in the past decades. The aim of our study was to analyze local and systemic morbidity and mortality, as well as functional results in this frail cohort treated with distal femur locking plates. Materials and methods: In this single-institution case series, we retrospectively analyzed the data of patients aged 65 years and older with fractures of the distal femur between March 2013 and March 2018. All patients were operated with distal femur locking plates. Points of interest included perioperative morbidity, mortality, weight-bearing status, and care-dependency after hospital discharge. Results: We assessed 49 patients (median age: 86.5 years) with 52 distal femur fractures (AO type A 77%, type C 15%, type B 8%). A total of 30 (58%) periprosthetic fractures with 4 (8%) interimplant femur fractures were documented. The perioperative morbidity was 64%, and the 3-month and 1-year mortality rates were 29% and 35%, respectively. The local complication rate was 6% with no documented implant failure. Of the patients who were living at home before the surgery, 62% required long-term accommodation in residential or nursing homes after dicharge from the hospital or short-term rehabilitation. Conclusions: Geriatric patients with distal femur fractures face a high perioperative mortality. Osteosynthesis with distal femur locking plates is a reliable technique that can be used in various fracture patterns including periprosthetic and interimplant fractures.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Distal Femur Fractures in Geriatric Patients

Loosen

Fritz

Dietrich

2019

Geriatr Orthop Surg Rehabil

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“…Distal femoral fractures often occur in elderly osteoporotic indivuduals witih poor bone stock. The difficulties of fixation and achieving union in these patients has been reported by several investigators, with non-union rates ranging from 10–25% and implant failure rates ranging from 5–16% in recent reports of locked lateral plating (15–21). When laterally-based plate fixation methods are used, endosteal allografts can aid in the reduction of the medial cortex, provide medial column support to enhance the biomechanical stability of the construct, and provide additional cortices for improved screw purchase.…”

Section: Introductionmentioning

confidence: 90%

The Use of Fibular Allograft in Complex Periarticular Fractures Around the Knee

Levack

Gadinsky

Gausden

et al. 2018

Operative Techniques in Orthopaedics

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Although the use of fibular strut allografts in proximal humerus fractures has gained popularity, their use in other types of fractures is less well described. Fibular allografts have recently been used in the repair of complex periarticular fractures of the proximal tibia and distal femur. Fibular allografts can be inserted in a variety of manners to achieve goals specific to each individual fracture pattern. In the proximal tibia, insertion through a fracture line or cortical window facilitates joint surface elevation, prevents subsidence and enhances overall construct stability. In distal femoral fractures, including complex periarticular fractures, insertion through the fracture or cortical window permits indirect reduction of the medial cortex and provides necessary medial column support. An additional option in distal femur fractures includes fibula insertion as an intramedullary nail, allowing enhanced fixation in short distal fracture segments. In all cases, the use of a fibular allograft augments poor bone stock and provides improved screw purchase and construct stability when combined with conventional plating methods. Here we present a series of cases at our institution illustrating an array of novel techniques utilizing endosteal fibular allografts in the fixation of complex periarticular fractures about the knee.

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“…In klinischen und biomechanischen Studien haben polyaxiale winkelstabile Implantate im distalen Radius einen Vorteil bezüglich der Weichteilkomplikationen gegenüber normalen winkelstabilen Implantaten gezeigt bei gleicher oder besserer Stabilität [8,9]. Durch eine geringere Torsionssteifigkeit haben polyaxiale winkelstabile Platten bei lasttragenden Knochen der unteren Extremität ein erhöhtes Risiko ein frühzeitiges Implantatversagen zu erleiden als konventionelle winkelstabile Implantate [10,11].…”

Section: Die Steifigkeit Dieses Konstruktes (Der Widerstand Gegenunclassified

Winkelstabile Plattenosteosynthese

Rußow¹,

Schütz²,

Berner³

2019

OP-JOURNAL

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ZusammenfassungDie winkelstabile Plattenosteosynthese ist aus der modernen Unfallchirurgie und Orthopädie nicht mehr wegzudenken. Sie hat unterschiedliche Entwicklungsschritte durchgemacht, bis sie schließlich bei dem Produkt angekommen ist, das heute so weit verbreitet ist. Dieser Artikel liefert eine Einführung in die Grundlagen der winkelstabilen Plattenosteosynthese.

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Early Mechanical Failures of the Synthes Variable Angle Locking Distal Femur Plate

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 69 publications

References 18 publications

Surgical Treatment of Distal Femur Fractures in Geriatric Patients

Surgical Treatment of Distal Femur Fractures in Geriatric Patients

The Use of Fibular Allograft in Complex Periarticular Fractures Around the Knee

Winkelstabile Plattenosteosynthese

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