Locked Lateral Plating Versus Retrograde Nailing for Distal Femur Fractures: A Multicenter Randomized Trial.

Autor:	Dunbar RP; Department of Orthopaedics and Sports Medicine, Harborview Medical Center/University of Washington, Seattle, WA., Egol KA; Department of Orthopaedic Surgery, NYU Langone Health, New York, NY., Jones CB; Department of Orthopaedic Surgery, Creighton University Medical, Dignity Health, Phoenix, AZ., Ertl JP; Department of Orthopaedic Surgery, Indiana Health University Hospital, Indianapolis, IN., Mullis B; Department of Orthopaedic Surgery, Indiana Health University Hospital, Indianapolis, IN., Perez E; Department of Orthopaedic Surgery, The Campbell Clinic, Nashville, TN., Collinge CA; Orthopaedic Specialty Associates, Fort Worth, TX., Ostrum R; UNC Orthopaedics, University of North Carolina, Chapel Hill, NC., Humphrey C; Department of Orthopaedics and Physical Performance, University of Rochester, Rochester, NY., Gardner MJ; Department of Orthopaedic Surgery, Stanford Medicine, Palo Alto, CA., Ricci WM; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY., Phieffer LS; Department of Orthopaedics, Ohio State University School of Medicine, Columbus, OH., Teague D; Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma College of Medicine, Oklahoma City, OK., Ertl W; Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma College of Medicine, Oklahoma City, OK., Born CT; Department of Orthopaedics, Brown University, Providence, RI., Zonno A; Department of Orthopaedics, Brown University, Providence, RI., Siegel J; UNC Orthopaedics, University of North Carolina, Chapel Hill, NC., Sagi HC; Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH., Pollak A; Department of Orthopaedics, R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD., Schmidt AH; Department of Orthopaedic Surgery, University of Minnesota School of Medicine, Minneapolis, MN., Templeman DC; Department of Orthopaedic Surgery, University of Minnesota School of Medicine, Minneapolis, MN., Sems A; Department of Orthopedic Surgery, The Mayo Clinic Hospital, St. Mary's Campus, Rochester, MN., Friess DM; Department of Orthopaedics and Rehabilitation, Oregon Health Sciences University, Portland, OR., Pape HC; Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA., Krieg JC; Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA; and., Tornetta P 3rd; Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic trauma [J Orthop Trauma] 2023 Feb 01; Vol. 37 (2), pp. 70-76.
DOI:	10.1097/BOT.0000000000002482
Abstrakt:	Objectives: The 2 main forms of treatment for distal femur fractures are locked lateral plating and retrograde nailing. The goal of this trial was to determine whether there are significant differences in outcomes between these forms of treatment. Design: Multicenter randomized controlled trial. Setting: Twenty academic trauma centers. Patients/participants: One hundred sixty patients with distal femur fractures were enrolled. One hundred twenty-six patients were followed 12 months. Patients were randomized to plating in 62 cases and intramedullary nailing in 64 cases. Intervention: Lateral locked plating or retrograde intramedullary nailing. Main Outcome Measurements: Functional scoring including Short Musculoskeletal Functional Assessment, bother index, EQ Health, and EQ Index. Secondary measures included alignment, operative time, range of motion, union rate, walking ability, ability to manage stairs, and number and type of adverse events. Results: Functional testing showed no difference between the groups. Both groups were still significantly affected by their fracture 12 months after injury. There was more coronal plane valgus in the plating group, which approached statistical significance. Range of motion, walking ability, and ability to manage stairs were similar between the groups. Rate and type of adverse events were not statistically different between the groups. Conclusions: Both lateral locked plating and retrograde intramedullary nailing are reasonable surgical options for these fractures. Patients continue to improve over the course of the year after injury but remain impaired 1 year postoperatively. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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