Minimally invasive fracture stabilization of distal femoral fractures with the LISS: A prospective multicenter study results of a clinical study with special emphasis on difficult cases

Schütz, Michael; Müller, Mathias; Krettek, Christian; Höntzsch, D; Regazzoni, P.; Ganz, Reinhold; Haas, Norbert

doi:10.1016/s0020-1383(01)00183-8

Cited by 307 publications

(200 citation statements)

References 4 publications

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“…Although various treatment alternatives were performed in the hip fracture group, we included only fractures of the distal femur managed with lateral locked plating. Even though similar results have been reported for this treatment modality and retrograde nailing, locked plating is the standard treatment at our institution as it allows fixation in very distal fractures, allows use of the plate for fracture reduction, and in our experience, leads to more reliable fracture alignment [27,31,38,40].…”

Section: Discussionsupporting

confidence: 54%

Mortality After Distal Femur Fractures in Elderly Patients

Streubel

Ricci

Wong

et al. 2011

Clinical Orthopaedics &Amp; Related Research

237

163

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Background Hip fractures in the elderly are associated with high 1-year mortality rates, but whether patients with other lower extremity fractures are exposed to a similar mortality risk is not clear. Questions/purposes We evaluated the mortality of elderly patients after distal femur fractures; determined predictors for mortality; analyzed the effect of surgical delay; and compared survivorship of elderly patients with distal femur fractures with subjects in a matched hip fracture group. Patients and Methods We included 92 consecutive patients older than 60 years with low-energy supracondylar femur fractures treated between 1999 and 2009. Patient, fracture, and treatment characteristics were extracted from operative records, charts, and radiographs. Data regarding mortality were obtained from the Social Security Death Index. Results Age-adjusted Charlson Comorbidity Index and a previous TKA were independent predictors for decreased survival. Congestive heart failure, dementia, renal disease,

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Section: Discussionsupporting

confidence: 54%

Mortality After Distal Femur Fractures in Elderly Patients

Streubel

Ricci

Wong

et al. 2011

Clinical Orthopaedics &Amp; Related Research

237

163

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“…8,9,14,15 Locking compression plate outcomes are favourable in osteoporotic bone and in fractures associated with marked comminution due to rigidity of plate screw construct. 16 The locking compression plate offer multiple points of fixed plate to screws contact, create greater stability and thereby minimize the susceptibility of varus collapse.…”

Section: Discussionmentioning

confidence: 99%

Management of distal femur fractures with locking compression plate: a prospective study

Konuganti

Jakinapally

Rao³

et al. 2018

Int J Res Orthop

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Background: Distal femur fractures need to be treated operatively to achieve optimal outcomes. Different types of internal fixation devices have been used but, the number of revisions for non-union, loss of reduction and implant failure has been high.Methods: This prospective study reviewed 20 cases of distal femoral fractures surgically managed with distal femoral locking compression plate between December 2013 and December 2015 at Mediciti Institute of medical sciences, Ghanpur, Medchal, tertiary care referral and trauma centre. Fractures were categorized according to OTA classification by Muller.Results: Highest number of patients was in their 3rd decade (25%) 18 out of 20 patients had closed injury. Type A2 Muller’s fracture was the most common fracture type 7 out of 20 patients (35%).The mean follow up period in this study was 8 months. The average range of knee flexion achieved was about 109°. The mean score 81.75 points were rated using Neer’s functional score (Max 100). Conclusions: The locking compression plate is the treatment of choice in the management of comminuted distal femoral fractures especially Type A fractures where we have found higher Neer scores. It may not completely solve the age-old problems associated with any fracture like non-union and malunion, but is valuable in the management of these fractures.

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“…If we speculated all these 16 fractures healed, the study nonunion rate would decrease to 14 of 86 (16%). Although some authors have reported a 100% union rate in small series [6,16,31,34,35], most larger series have found a substantial rate of healing difficulties [6,20,[27][28][29]32]. When nonunion, delayed union, the need for secondary surgery, and hardware failure are considered, the rate of healing difficulties reported in the literature is comparable to the rate in our study (Table 6) [6, 7, 11, 14-16, 20, 27-29, 31, 32, 34, 35].…”

Section: Discussionmentioning

confidence: 99%

2010 Mid-America Orthopaedic Association Physician in Training Award: Healing Complications Are Common After Locked Plating for Distal Femur Fractures

Henderson

Lujan²,

Kuhl

et al. 2011

Clinical Orthopaedics &Amp; Related Research

181

143

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Background Several mechanical studies suggest locking plate constructs may inhibit callus necessary for healing of distal femur fractures. However, the rate of nonunion and factors associated with nonunion are not well established. Questions/purposes We (1) determined the healing rate of distal femur fractures treated with locking plates, (2) assessed the effect of patient injury and treatment variables on fracture healing, and (3) compared callus formation in fractures that healed with those that did not heal. Patients and MethodsWe retrospectively reviewed 82 patients treated with 86 distal femur fractures using lateral locking plates. We reviewed all charts and radiographs to determine patient and treatment variables and then determined the effects of these variables on healing. We quantitatively measured callus at 6, 12, and 24 weeks.The minimum time for telephone interviews and SF-36v2 TM scores was 1 year (mean, 4.2 years; range, 1-7.2 years). Results Fourteen fractures (20%) failed to unite. Demographics and comorbidities were similar in patients who achieved healing compared with those who had nonunions. There were more empty holes in the plate adjacent to fractures that healed; comminuted fractures failed to heal more frequently than less comminuted fractures. Less callus formed in fractures with nonunions and in patients treated with stainless steel plates compared with titanium plates. Complications occurred in 28 of 70 fractures (40%), 19 of which had additional surgery. Conclusions We found a high rate of nonunion in distal femur fractures treated with locking plates. Nonunion presented late without hardware failure and with limited callus formation suggesting callus inhibition rather than hardware failure is the primary problem. Mechanical factors may play a role in the high rate of nonunion. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Minimally invasive fracture stabilization of distal femoral fractures with the LISS: A prospective multicenter study results of a clinical study with special emphasis on difficult cases

Cited by 307 publications

References 4 publications

Mortality After Distal Femur Fractures in Elderly Patients

Mortality After Distal Femur Fractures in Elderly Patients

Management of distal femur fractures with locking compression plate: a prospective study

2010 Mid-America Orthopaedic Association Physician in Training Award: Healing Complications Are Common After Locked Plating for Distal Femur Fractures

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