Refracture after removal of a condylar plate from the distal third of the femur.

Of 103 patients who had a fracture of the distal third of the femur that was treated by open reduction and internal fixation with a condylar blade-plate, sixty-two had removal of the plate after the fracture had united. The mean interval between injury and removal of the plate was twenty-six months. Six patients (10 per cent) sustained a refracture that was unrelated to major trauma; the refracture occurred twelve to ninety-three days after removal of the plate. Five of the six refractures occurred through a hole of a supplemental interfragmentary lag-screw. The use of such screws significantly increased the risk of refracture after removal of the hardware (p less than 0.01). The refractures were treated by intramedullary nailing in five patients and by replating in one, and union was achieved in all six patients. Routine removal of a condylar blade-plate after union of a fracture of the distal third of the femur cannot be recommended, especially in the presence of supplemental fixation with interfragmentary screws.