Medial augmentation plating of aseptic distal femoral nonunions.
Augmentation plating
Distal femur
Femoral nonunion
Implant failure
Medial plate
Pseudarthrosis
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
05 Jul 2023
05 Jul 2023
Historique:
received:
28
10
2022
accepted:
27
06
2023
medline:
7
7
2023
pubmed:
6
7
2023
entrez:
5
7
2023
Statut:
epublish
Résumé
Distal femur nonunions are well-recognized contributors to persistent functional disability, with limited data regarding their treatment options. In the current study, we asked whether additional medial augmentation plating is a feasible treatment option for patients with aseptic distal femoral nonunion and intact lateral implants. We conducted a single-center, retrospective study including 20 patients treated for aseptic distal femoral nonunion between 2002 and 2017. The treatment procedure included a medial approach to the distal femur, debridement of the nonunion site, bone grafting and medial augmentation plating utilizing a large-fragment titanium plate. Outcome measures were bone-related and functional results, measured by the Hospital for Special Surgery Knee Rating Scale (HSS) and the German Short Musculoskeletal Function Assessment questionnaire (SMFA-D). Eighteen of 20 nonunions showed osseous healing at 8.16 ± 5.23 (range: 3-21) months after augmentation plating. Regarding functional results, the mean HSS score was 74.17 ± 11.12 (range: 57-87). The mean SMFA-D functional index was 47.38 ± 16.78 (range 25.74-71.32) at the last follow-up. Index procedure-associated complications included two cases of persistent nonunion and one case of infection. According to the assessed outcome measures, augmentation plating is a feasible treatment option, with a high proportion of patients achieving bony union and good functional outcomes and a few patients experiencing complications.
Sections du résumé
BACKGROUND
BACKGROUND
Distal femur nonunions are well-recognized contributors to persistent functional disability, with limited data regarding their treatment options. In the current study, we asked whether additional medial augmentation plating is a feasible treatment option for patients with aseptic distal femoral nonunion and intact lateral implants.
METHODS
METHODS
We conducted a single-center, retrospective study including 20 patients treated for aseptic distal femoral nonunion between 2002 and 2017. The treatment procedure included a medial approach to the distal femur, debridement of the nonunion site, bone grafting and medial augmentation plating utilizing a large-fragment titanium plate. Outcome measures were bone-related and functional results, measured by the Hospital for Special Surgery Knee Rating Scale (HSS) and the German Short Musculoskeletal Function Assessment questionnaire (SMFA-D).
RESULTS
RESULTS
Eighteen of 20 nonunions showed osseous healing at 8.16 ± 5.23 (range: 3-21) months after augmentation plating. Regarding functional results, the mean HSS score was 74.17 ± 11.12 (range: 57-87). The mean SMFA-D functional index was 47.38 ± 16.78 (range 25.74-71.32) at the last follow-up. Index procedure-associated complications included two cases of persistent nonunion and one case of infection.
CONCLUSIONS
CONCLUSIONS
According to the assessed outcome measures, augmentation plating is a feasible treatment option, with a high proportion of patients achieving bony union and good functional outcomes and a few patients experiencing complications.
Identifiants
pubmed: 37407946
doi: 10.1186/s12891-023-06675-5
pii: 10.1186/s12891-023-06675-5
pmc: PMC10324211
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
554Informations de copyright
© 2023. The Author(s).
Références
J Am Acad Orthop Surg. 2019 Jul 15;27(14):e659-e663
pubmed: 30407980
Unfallchirurgie (Heidelb). 2022 Aug;125(8):602-610
pubmed: 35750886
J Orthop Trauma. 1995 Feb;9(1):63-5
pubmed: 7714656
Orthop Surg. 2013 Feb;5(1):46-50
pubmed: 23420747
Clin Orthop Relat Res. 1996 Jun;(327):272-82
pubmed: 8641074
Eur J Orthop Surg Traumatol. 2019 Jan;29(1):189-196
pubmed: 29931530
J Bone Joint Surg Am. 2010 Dec;92 Suppl 2:12-22
pubmed: 21123589
Injury. 2005 Nov;36 Suppl 4:S30-7
pubmed: 16291321
Injury. 2014 Dec;45 Suppl 6:S93-7
pubmed: 25457326
J Bone Joint Surg Am. 2002 Feb;84(2):208-15
pubmed: 11861726
J Orthop Trauma. 2010 Mar;24(3):156-62
pubmed: 20182251
J Bone Joint Surg Am. 1992 Jun;74(5):659-70
pubmed: 1378056
Iowa Orthop J. 2010;30:61-8
pubmed: 21045973
J Arthroplasty. 1993 Feb;8(1):49-55
pubmed: 8436989
Int Orthop. 2005 Oct;29(5):287-90
pubmed: 16132986
JBJS Rev. 2016 Jun 14;4(6):
pubmed: 27486720
Musculoskelet Surg. 2020 Aug;104(2):215-226
pubmed: 31243698
Cochrane Database Syst Rev. 2015 Aug 13;(8):CD010606
pubmed: 26270891
Injury. 2006 May;37 Suppl 2:S59-66
pubmed: 16651073
JBJS Rev. 2015 Mar 17;3(3):
pubmed: 27490889
J Orthop Surg Res. 2013 Nov 27;8:43
pubmed: 24279475
Injury. 2007 Sep;38 Suppl 4:S3-6
pubmed: 18224731
J Orthop Trauma. 2011 Feb;25 Suppl 1:S8-14
pubmed: 21248560
J Trauma. 2008 Feb;64(2):434-8
pubmed: 18301211
Int Orthop. 2018 Nov;42(11):2675-2683
pubmed: 29516238
J Orthop Trauma. 1995;9(4):285-91
pubmed: 7562149
Clin Orthop Relat Res. 2016 Jun;474(6):1498-505
pubmed: 26797911
Qual Life Res. 2015 Aug;24(8):2015-23
pubmed: 25676859
J Orthop Trauma. 2002 May;16(5):287-96
pubmed: 11972070
J Orthop Trauma. 2020 Jan;34(1):8-17
pubmed: 31855973
J Trauma. 2011 Aug;71(2):E26-30
pubmed: 21248652
J Bone Joint Surg Am. 1982 Jul;64(6):871-9
pubmed: 7085714
Orthop Traumatol Surg Res. 2012 Feb;98(1):97-102
pubmed: 22244249
Occup Med (Lond). 2016 Dec;66(9):757
pubmed: 27994082
Arch Orthop Trauma Surg. 2022 Jun;142(6):1009-1030
pubmed: 33484313
J Orthop Trauma. 2018 Jan;32 Suppl 1:S1-S170
pubmed: 29256945
J Orthop Trauma. 2014 Feb;28(2):83-9
pubmed: 23760176
J Trauma. 1991 Dec;31(12):1659-62
pubmed: 1749039
J Orthop Res. 2000 Mar;18(2):289-302
pubmed: 10815831
J Orthop Trauma. 2001 Nov;15(8):574-8
pubmed: 11733676
Arch Orthop Trauma Surg. 2016 May;136(5):631-8
pubmed: 26852379
J Bone Joint Surg Am. 1999 Sep;81(9):1217-28
pubmed: 10505518
J Orthop Trauma. 2018 Feb;32 Suppl 1:S35-S39
pubmed: 29373450
J Orthop Surg Res. 2020 Apr 15;15(1):144
pubmed: 32293488
J Orthop Trauma. 2019 Nov;33(11):547-552
pubmed: 31403558
Arch Orthop Trauma Surg. 2021 Feb;141(2):225-233
pubmed: 32388648