Locked Plating of Distal Femur Fractures Leads to Inconsistent and Asymmetric Callus Formation
| Autor: | J. Lawrence Marsh, Chris E. Henderson, Michael Bottlang, Daniel C. Fitzpatrick, Trevor J. Lujan, Steven M. Madey |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Callus formation Bone healing Locked plating Prosthesis Design Cohort Studies Fracture Fixation Internal Bone plate Fracture fixation medicine Humans Orthopedics and Sports Medicine Femur Bony Callus Retrospective Studies Fracture Healing Titanium business.industry General Medicine Anatomy Middle Aged Stainless Steel musculoskeletal system Prosthesis Failure Radiography Callus Orthopedic surgery Female Surgery business Bone Plates Femoral Fractures Biomedical engineering |
| Zdroj: | Journal of Orthopaedic Trauma. 24:156-162 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0b013e3181be6720 |
| Popis: | Locked plating constructs may be too stiff to reliably promote secondary bone healing. This study used a novel imaging technique to quantify periosteal callus formation of distal femur fractures stabilized with locking plates. It investigated the effects of cortex-to-plate distance, bridging span, and implant material on periosteal callus formation.Retrospective cohort study.One Level I and one Level II trauma center.Sixty-four consecutive patients with distal femur fractures (AO types 32A, 33A-C) stabilized with periarticular locking plates.Osteosynthesis using indirect reduction and bridge plating with periarticular locking plates.Periosteal callus size on lateral and anteroposterior radiographs.Callus size varied from 0 to 650 mm2. Deficient callus (20 mm2 or less) formed in 52%, 47%, and 37% of fractures at 6, 12, and 24 weeks postsurgery, respectively. Callus formation was asymmetric, whereby the medial cortex had on average 64% more callus (P=0.001) than the anterior or posterior cortices. A longer bridge span correlated minimally with an increased callus size at Week 6 (P=0.02), but no correlation was found at Weeks 12 and 24 postsurgery. Compared with stainless steel plates, titanium plates had 76%, 71%, and 56% more callus at Week 6 (P=0.04), Week 12 (P=0.03), and Week 24 (P=0.09), respectively.Stabilization of distal femur fractures with periarticular locking plates can cause inconsistent and asymmetric formation of periosteal callus. A larger bridge span only minimally improves callus formation. The more flexible titanium plates enhanced callus formation compared with stainless steel plates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|