‘Modern’ distal femoral locking plates allow safe, early weight-bearing with a high rate of union and low rate of failure
| Autor: | E. Guryel, S. F. Bellringer, H. C. Guthrie, D. G. G. Wilson, S. G. Nicol, Richard Freeman, W. E. C. Poole |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Weight-Bearing Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Fracture fixation medicine Humans Orthopedics and Sports Medicine Treatment Failure 030212 general & internal medicine education Aged Fixation (histology) Aged 80 and over 030222 orthopedics education.field_of_study business.industry Mortality rate Major trauma Incidence (epidemiology) Femoral fracture Middle Aged medicine.disease United Kingdom Surgery Treatment Outcome Radiological weapon Female business Bone Plates Femoral Fractures Osteoporotic Fractures |
| Zdroj: | The Bone & Joint Journal. :951-957 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.99b7.bjj-2016-0585.r1 |
| Popis: | Aims Fractures of the distal femur can be challenging to manage and are on the increase in the elderly osteoporotic population. Management with casting or bracing can unacceptably limit a patient’s ability to bear weight, but historically, operative fixation has been associated with a high rate of re-operation. In this study, we describe the outcomes of fixation using modern implants within a strategy of early return to function. Patients and Methods All patients treated at our centre with lateral distal femoral locking plates (LDFLP) between 2009 and 2014 were identified. Fracture classification and operative information including weight-bearing status, rates of union, re-operation, failure of implants and mortality rate, were recorded. Results A total of 127 fractures were identified in 122 patients. The mean age was 72.8 years (16 to 101) and 92 of the patients (75%) were female. A consultant performed the operation in 85 of the cases, (67%) with the remainder performed under direct consultant supervision. In total 107 patients (84%) were allowed to bear full weight immediately. The rate of clinical and radiological union was 81/85 (95%) and only four fractures of 127 (3%) fractures required re-operation for failure of surgery. The 30-day, three- and 12-month mortality rates were 6 (5%), 17 (15%) and 25 (22%), respectively. Conclusion Our study suggests an exponential increase in the incidence of a fracture of the distal femur with age, analogous to the population suffering from a proximal femoral fracture. Allowing immediate unrestricted weight-bearing after LDFLP fixation in these elderly patients was not associated with failure of fixation. There was a high rate of union and low rate of re-operation. Cite this article: Bone Joint J 2017;99-B:951–7. |
| Databáze: | OpenAIRE |
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