Mid Term Results of Distal Femoral Fractures Treated with a Polyaxial Locking Plate: A Multi-Center Study

Abstract

Objective : Locking plates have become a standard implant in the treatment of distal femoral fractures. Newer designs allow polyaxial screw placement as well as the ability to lock the lag screws. Methods : The consecutive multi-centre study cohort consists of all distal femoral fractures treated with the NCB® Distal Femur plate (Zimmer, Warsaw, USA) and a minimum follow-up of twelve months. Fracture classification according the AO/ OTA system and the trauma mechanism radiological evaluation and complications were documented. Clinical evaluation consisted of the Short Form SF12 questionnaire (SF12), the Hospital for Special Surgery Score (HSS) and clinical assessment of range of motion.Results : Twenty-five patients with twenty-six fractures were available for follow-up with a minimum required follow-up of twelve months. 81% of the fractures were intra-articular. 48% of the patients were multi-traumatised, 38% having open fractures. All except two went to union (92%) with the primary procedure. The HSS Score was 79 (32-99) and the SF 12 (physical and mental) 40 (19-57) and 54 (21-66) at follow-up. There were five patients requiring surgical revision (19%). Conclusion : These fractures are often combined with concomitant injuries. Using modern locked implants high union rates can be achieved with a good function and patient satisfaction when respecting biologic and biomechanical principles.

Functional Outcome of Surgical Management of AO Type-C Fractures of Distal Femur Treated with Distal Femoral Locking Platesusing Swashbuckler Approach

“…We achieved 70 % excellent results at one year follow up and bony union in all cases within 24 weeks. In our study, radiological union was seen at an average of 17.35 weeks which is comparable to study of distal femur fractures by polyaxial plating by Pascarella, et al, and J B Erhardt, et al, [16,17].…”

Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision

“…The SF-12 score after two years was 46.4, the HSS score was 86 which is comparable to that of similar patients [3] .The 4-second peak load during the last two years is shown in Supplemental Fig. 1 and shows a decrease in strength of the affected leg in the past six months, ever since focus of physical therapy has changed from muscle strength to coordination.…”

“…A distal femur NCB-plate (Zimmer, Warsaw, USA) was placed laterally ( Fig. 1 ) as this plate showed good results previously [3] , [4] . A straight small fragment LCP plate (DePuy Synthes, Raynham, USA) was placed medially followed by eight weeks non-weightbearing.…”

Total femur fixation using the “nail-plate docking technique” for ipsilateral femur shaft fracture

“…Many screws of conventional locking plates have monoaxial directional restriction. In contrast, the screw of the Non-Contact-Bridging (NCB) locking plate system has polyaxial flexibility up to 30 degrees while maintaining enough mechanical strength [2] , [3] , [4] . The nut of the NCB locking system can maintain the screw angular stability and prevent the back-out of the screws ( Fig.…”