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

Is nail-plate docking worth the effort? A biomechanical analysis of docking a plate and a nail in peri-implant femur fractures

“…Normal implant placement without docking is an easier procedure that requires less extensive radiological scanning for screw placement ( Cheng et al, 2017 ; Cheng et al, 2018 ; McGain et al, 2020 ). Regarding the ideal technique, the use of polyaxially locking plates compared with monoaxially locking plates is time-saving, as is the use of a dynamic hole of distal interlocking screw rather than a static hole of distal interlocking screw, the latter of which has been reported by Takai et al ( Hanschen et al, 2014 ; Takai et al, 2022 ). In clinical practice, changing the nail to a longer implant instead of plating is preferred by some surgeons; however, Goodnough et al revealed that revision to a longer nail instead of plating is associated with increased mortality ( Goodnough et al, 2021 ).…”

“…In most cases, PIFFs occur around a pre-existing nail or plate, and a treatment strategy might require a combination of a nail with a plate. Usually, the two implants lack a link to each other ( Figure 1A ); however, it is also possible to connect them using a screw that runs through the hole of the distal interlocking screw of the cephalomedullary nail and the screw hole of the plate, thereby creating a nail–plate docking system ( Figure 1B ; Takai et al, 2022 ). Currently, the biomechanical effect of the nail–plate docking technique is unclear.…”

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“…Normal implant placement without docking is an easier procedure that requires less extensive radiological scanning for screw placement (Cheng et al, 2017;Cheng et al, 2018;McGain et al, 2020). Regarding the ideal technique, the use of polyaxially locking plates compared with monoaxially locking plates is time-saving, as is the use of a dynamic hole of distal interlocking screw rather than a static hole of distal interlocking screw, the latter of which has been Frontiers in Bioengineering and Biotechnology frontiersin.org reported by Takai et al (Hanschen et al, 2014;Takai et al, 2022). In clinical practice, changing the nail to a longer implant instead of plating is preferred by some surgeons; however, Goodnough et al revealed that revision to a longer nail instead of plating is associated with increased mortality (Goodnough et al, 2021).…”