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Archives of Orthopaedic and Trauma Surgery

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Open Access 22-06-2023 | Femoral Fracture | Trauma Surgery

The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur

Authors: Chang-Heng Liu, Ping-Jui Tsai, I-Jung Chen, Yi-Hsun Yu, Ying-Chao Chou, Yung-Heng Hsu

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2023

Abstract

Introduction

Varus collapse followed by osteosynthesis for distal femoral fractures with conventional implants has been well documented but is seldom mentioned in fractures managed with locking plates. The purpose of this study was to assess the incidence of varus collapse after treating complex supra-intercondylar fractures of the distal femur (AO type C3) using a Single Plate (SP) or Double Plate (DP) fixation technique.

Materials and methods

We retrospectively reviewed 357 patients with distal femoral fractures who were treated at our hospital between 2006 and 2017. After excluding cases of infection, malignancy, periprosthetic fracture, revision surgery, pediatric fracture, and extra-articular fracture, 54 patients were included in the study. All demographic data and radiological and clinical outcomes were reviewed and analyzed.

Results

There were 54 patients enrolled into this study with age from 15 to 85 years old (mean 41.6, SD = 19.9), and 32 of them were open fractures (59%). The patients were further divided into either an SP (n = 15) or a DP group (n = 39). Demographics, including age, sex, injury severity score, and open fracture type, were all compatible between the two groups. The overall nonunion rate was 25.9% (n = 14; 6 from the SP and 8 from the DP group; p = 0.175). The varus collapse rate was 9.3% (n = 5; 4 from the SP and 1 from the DP group (p = 0.018).

Conclusions

The varus collapse rate after osteosynthesis with a single lateral locking plate could be as high as 26.7% in AO type C3 fractures of the distal femur, which would be decreased to 2.6% by adding a medial buttress plate. Surgeons should consider DP fixation to avoid varus collapse in severely comminuted complete intra-articular fractures of the distal femur.

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Title: The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur
Authors: Chang-Heng Liu
Ping-Jui Tsai
I-Jung Chen
Yi-Hsun Yu
Ying-Chao Chou
Yung-Heng Hsu
Publication date: 22-06-2023
Publisher: Springer Berlin Heidelberg
Keyword: Femoral Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04953-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The double-plate fixation technique prevents varus collapse in AO type C3 supra-intercondylar fracture of the distal femur

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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