Periprosthetic distal femur fractures treated by retrograde intramedullary nails with a 10-degree distal bend achieve significantly better post-operative radiographic alignment when compared to conventional retrograde nails

Kerr, Matthew S.; Young, Everett; Shaath, M. Kareem; Avilucea, Frank R.; Adigweme, Obinna O.; Haidukewych, George J.

doi:10.1016/j.injury.2022.11.029

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Modern retrograde nail systems incorporate multiple distal interlocking bolt options to increase fixation in the short segment. The DePuy Synthes (West Chester, PA) Retrograde Femoral Nailing Advanced (RFNA) is a newer implant that has gained recent popularity for the treatment of distal femur fractures [17]. In theory, this implant contains a "locking polymer" within the distal nail body to constrain the distal interlock screws and create a fixed angle relationship between the screws and nail.…”

Section: Introductionmentioning

confidence: 99%

Rates of interlock screw back-out are high with the retrograde femoral nailing advanced system for distal femur fractures

Bhale,

Campbell,

Fitzpatrick

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose The retrograde femoral nailing advanced (RFNA) system (DePuy synthes) is a commonly used implant for the fixation of low distal femur and periprosthetic fractures. There is concern that the rate of distal interlock screw back-out may be higher for the RFNA compared to other nails (ON). The purpose of this study was to evaluate the incidence of interlock screw back-out and associated screw removal for RFNA versus ON, along with associated risk factors. Methods A retrospective comparative study of patients who underwent retrograde nailing for a distal femur fracture at an academic level one trauma center was performed. The incidence of distal interlock screw back-out and need for screw removal were compared for RFNA versus a propensity score matched cohort who received other nails. Results One hundred and ten patients underwent retrograde nailing with the RFNA for a distal femur fracture from 2015 to 2022 (average age: 66, BMI: 32, 52.7% smokers, 54.5% female, 61.8%). There was a significantly higher rate of interlock back-out in the RFNA group compared to the ON (27 patients, 24.5% vs 12 patients, 10.9%, p = 0.01), which occurred 6.3 weeks postoperatively. Screw removal rates for back-out were not significantly different for the RFNA group versus ON (8 patients, 7.3% vs 3 patients, 2.7%, p = 0.12). Conclusion In this retrospective comparative study of distal femur fractures treated with retrograde nailing, the RFNA implant was associated with an increased risk of distal interlock screw back-out compared to other nails.

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Section: Introductionmentioning

confidence: 99%

Rates of interlock screw back-out are high with the retrograde femoral nailing advanced system for distal femur fractures

Bhale,

Campbell,

Fitzpatrick

et al. 2024

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

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“…Currently, studies related to distal femoral fractures have focused on internal implant fixation techniques and postoperative complication management. Among them, adverse outcomes after distal femoral comminuted metaphyseal bone surgery are frequently reported, such as delayed or non-union of the fracture, joint stiffness, plate fracture, and loss of alignment after anatomical reduction (Henderson et al, 2011;Kim et al, 2017;Bologna et al, 2020;Chandra Vemulapalli et al, 2022;Kerr et al, 2022). However, there are few studies on the morphological systems of distal femoral fractures, and the lack of exploration of the morphological characteristics of this type of fracture may hinder the optimization of surgical fixation strategies and the design of internal implants for these complex fractures.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional computed tomography mapping techniques in the morphometric analysis of AO/OTA 33A and 33C distal femoral fractures: a retrospective single-center study

Chen

Zheng

Guo

et al. 2023

Front. Bioeng. Biotechnol.

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Purpose: Complex distal femoral fractures involve a challenging set of considerations that must be known to provide optimal management. This study aimed to determine the location and frequency of fracture lines and comminution zones in AO/OTA types 33A and 33C distal femoral fractures using three-dimensional computed tomography mapping.Methods: Seventy-four consecutive eligible patients were included. Fracture fragments for each patient were reconstructed, virtually reduced, and adjusted to match the distal femoral template. Then, all fracture lines and comminuted areas were extracted in transparent mode, and corresponding heat maps were constructed. Finally, these maps, along with the quantitative analysis findings of the counts and volumes of each fragment, were used to summarize the characteristics of the fractures.Results: Thirty-four females and 40 males [average age, 58 years (range, 18–92 years)] presented with a distal femoral fracture. There were 53 AO/OTA type 33A fractures, and 21 AO/OTA type 33C fractures. These two patterns differed significantly on fracture fragment count, comminuted zone fracture fragment count, and mean comminuted zone fracture fragment volume (p < 0.05). Most of the fracture line heat zones were in the femoral epiphysis, intercondylar notch of the femur, and patellofemoral joint. The comminuted area heat regions were mostly found on the lateral, anterior, and posterior femoral diaphysis, with less involvement on the medial side.Conclusion: Our findings may serve as a guide for the surgical approach selection of complex distal femur fractures, the placement strategy of the internal fixation, and the optimization of the osteotomy plan for biomechanical studies.

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Periprosthetic distal femur fractures treated by retrograde intramedullary nails with a 10-degree distal bend achieve significantly better post-operative radiographic alignment when compared to conventional retrograde nails

Cited by 2 publications

References 17 publications

Rates of interlock screw back-out are high with the retrograde femoral nailing advanced system for distal femur fractures

Rates of interlock screw back-out are high with the retrograde femoral nailing advanced system for distal femur fractures

Three-dimensional computed tomography mapping techniques in the morphometric analysis of AO/OTA 33A and 33C distal femoral fractures: a retrospective single-center study

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