Locked plating, immediate weight-bearing seen as safe for periprosthetic distal femur fractures
Investigators of this study found less-invasive locked plate fixation and unrestricted weight-bearing immediately afterward was safe and practical for the treatment of patients with periprosthetic distal femur fractures.
Researchers retrospectively observed 52 patients with a total of 54 periprosthetic distal femur fractures treated with locked plate fixation. A standardized institutional protocol was used for all patients which included admission to a hospitalist service from the emergency department, surgery within 24 hours of admission, standardized thromboembolic prophylaxis before surgery, minimally invasive locked plating and postoperative weight-bearing. There was also a standardized follow-up for 1 year.
The rate of postoperative complications was the primary outcome. Secondary outcomes included time to surgery, intraoperative blood loss, duration of surgery, length of hospital stay, time to full weight-bearing and radiographic healing. Follow-ups were performed at 2 weeks, 8 weeks, 14 weeks to 16 weeks, 6 months and 1 year.
Findings showed three implants failed. In addition, there was one nonunion and two patients had symptomatic malunion. Investigators noted patellar component instability correlated with valgus alignment in one patient and this caused knee pain. Although, there was consistent anticoagulation, 10 thromboembolic complications occurred.
Within 12 months of injury, two patients died. At the 1-year follow-up, 38 patients returned to their preinjury ambulation status. ‒ by Monica Jaramillo
Disclosures: Smith reports no relevant financial disclosures. Please see the full study for a list of all other author’s relevant financial disclosures.