12/7/2023 0 Comments Supracondylar fracture femurModern locked implants achieved high union rates with a good clinical function and patient satisfaction when respecting biologic and biomechanical principles Neither the type of the construct nor the hardware used influenced radiologic and clinical outcomes RIMN for aseptic supracondylar femoral nonunions following failed locked plating achieved a high union rateĪbsence of implant and fixation failure suggests that dynamic plating of distal femur fractures with far cortical locking screws provides safe and effective fixation RIMN is a good surgical option for distal femur fractures with osteoporosis as it promotes fracture healing and allows early mobilization RIMN of open distal femur fractures allows for early rehab of the affected joint and helps to reduce primary deformities and secondary degenerative lesions for a good treatment outcomeĭistal femoral nailing provides a good fixation method allowing immediate mobilization for elderly patients Retrograde femoral nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing Treatment of distal femur fractures with retrograde locked IMN yields satisfactory results in adults RIMSN is standard care, yet the biological osteosynthesis using DCS is a very good alternative for the treatement of distal femur fractures No implant or surgical technique is superior to any other under all circumstances for distal femur fractures. Less invasive techniques decreased the need for delayed bone grafting and decreased the malunion rate in this study IMN may be a superior treatment compared with anatomical locking plates for fractures of the distal femurĭF fractures treated with IMN have equivalent short-term outcomes compared to those treated with plate fixation Significantly less periosteal callus formed in fractures stabilized with locking plates than with IM nailsīoth retrograde IM nailing and angular stable plating are adequate treatment options, but clinical outcome largely depends on surgical technique rather than on the choice of implant The overall nonunion rate in the locked plating group was higher than in the RIMN group, though likely due to surgical technique rather than the choice of implant Nailing proved to be more cumbersome intraoperatively but showed an inclination towards earlier union, while LISS plating showed technical errors to be more common and less forgivingīridge plating and RIMN showed similar results in the treatment of extra-articular distal femur fractures In this systematic review, a step-wise methodical approach is performed to compare outcomes of distal femur fractures treated with either IMN or LP. However, while proponents of each treatment modality will debate on pros and cons of both IMN and LP, there is still no clear consensus on a gold standard when it comes to treating distal femur fractures. Continued understanding of surrounding anatomy, along with the concurrent metallurgic and biomechanical evolution of both IMN and LP technologies, results for both treatment modalities have been favorable in the recent literature. IMN typically is performed in the retrograde fashion, while LP can be performed via a midline or minimally invasive lateral approach. With rare indications for non-operative treatment, the majority of distal femur fractures are treated operatively via either intramedullary nailing (IMN) or locked plating (LP). Improper restoration of distal femoral anatomy can cause significant disability due to significant shifts in the anatomic and mechanical axis of the affected limb. Excessive deforming forces cause significant deformity, making this fracture clinically challenging to treat. Distal femur fractures make up < 1% of all fractures and 3–6% of all femur fractures.
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