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Low risk of nonunion with lateral locked plating of distal femoral fractures—A retrospective study of 191 consecutive patients

Wenger, Daniel LU and Andersson, Sanet (2019) In Injury 50(2). p.448-452
Abstract

Introduction: The reported rate of nonunion of distal femoral fractures varies in the literature. Several risk factors for nonunion following lateral locked plating (LLP) have been described. We aimed to study the rate of nonunion, and risk factors thereof, in a Swedish population where fragility fractures are common. A secondary aim was to study risk factors for reoperation for any cause. Patients and Methods: We retrospectively reviewed the hospital files and radiographs of all adult patients admitted to our institution with a distal femoral fracture, from 2004 through 2013. In cases treated with LLP, medical comorbidities, fracture characteristics and implant characteristics were analysed as potential risk factors for nonunion,... (More)

Introduction: The reported rate of nonunion of distal femoral fractures varies in the literature. Several risk factors for nonunion following lateral locked plating (LLP) have been described. We aimed to study the rate of nonunion, and risk factors thereof, in a Swedish population where fragility fractures are common. A secondary aim was to study risk factors for reoperation for any cause. Patients and Methods: We retrospectively reviewed the hospital files and radiographs of all adult patients admitted to our institution with a distal femoral fracture, from 2004 through 2013. In cases treated with LLP, medical comorbidities, fracture characteristics and implant characteristics were analysed as potential risk factors for nonunion, defined as any surgical intervention to improve healing. Results: There were 8 cases (4%, 95%CI: 1.8–8.1%) of nonunion in 191 fractures treated with LLP. Patients with nonunion were younger: 62 vs. 81 years (p = 0.009) and more commonly had open fractures: 38% vs. 9% (p = 0.034). No patient 80 years or older had a surgical intervention for nonunion. Lower age was independently associated with reoperation for any cause, but not for nonunion. Discussion: The low rate of nonunion in this study is probably due to the fact that we present data from a complete cohort from a geographic catchment area. Referral centres with a high proportion of young patients with high-energy injuries, may be better suited for studies on risk factors for nonunion, due to higher statistical power. However, results from such institutions may not be generalizable to the more common low-energy fractures.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Distal femoral fractures, Locked lateral plating, Nonunion, Reoperation
in
Injury
volume
50
issue
2
pages
448 - 452
publisher
Elsevier
external identifiers
  • scopus:85055910338
ISSN
0020-1383
DOI
10.1016/j.injury.2018.10.039
language
English
LU publication?
yes
id
0d7025f6-dd3d-425d-83fc-61652a2f1415
date added to LUP
2018-11-19 13:32:51
date last changed
2019-08-14 04:27:37
@article{0d7025f6-dd3d-425d-83fc-61652a2f1415,
  abstract     = {<p>Introduction: The reported rate of nonunion of distal femoral fractures varies in the literature. Several risk factors for nonunion following lateral locked plating (LLP) have been described. We aimed to study the rate of nonunion, and risk factors thereof, in a Swedish population where fragility fractures are common. A secondary aim was to study risk factors for reoperation for any cause. Patients and Methods: We retrospectively reviewed the hospital files and radiographs of all adult patients admitted to our institution with a distal femoral fracture, from 2004 through 2013. In cases treated with LLP, medical comorbidities, fracture characteristics and implant characteristics were analysed as potential risk factors for nonunion, defined as any surgical intervention to improve healing. Results: There were 8 cases (4%, 95%CI: 1.8–8.1%) of nonunion in 191 fractures treated with LLP. Patients with nonunion were younger: 62 vs. 81 years (p = 0.009) and more commonly had open fractures: 38% vs. 9% (p = 0.034). No patient 80 years or older had a surgical intervention for nonunion. Lower age was independently associated with reoperation for any cause, but not for nonunion. Discussion: The low rate of nonunion in this study is probably due to the fact that we present data from a complete cohort from a geographic catchment area. Referral centres with a high proportion of young patients with high-energy injuries, may be better suited for studies on risk factors for nonunion, due to higher statistical power. However, results from such institutions may not be generalizable to the more common low-energy fractures.</p>},
  author       = {Wenger, Daniel and Andersson, Sanet},
  issn         = {0020-1383},
  keyword      = {Distal femoral fractures,Locked lateral plating,Nonunion,Reoperation},
  language     = {eng},
  number       = {2},
  pages        = {448--452},
  publisher    = {Elsevier},
  series       = {Injury},
  title        = {Low risk of nonunion with lateral locked plating of distal femoral fractures—A retrospective study of 191 consecutive patients},
  url          = {http://dx.doi.org/10.1016/j.injury.2018.10.039},
  volume       = {50},
  year         = {2019},
}