Orlando Health Jewett Orthopedic Institute, Orlando, FL.
Florida State College of Medicine, Orlando, FL; and.
J Orthop Trauma. 2024 Nov 1;38(11):584-591. doi: 10.1097/BOT.0000000000002899.
The objective of this study was to report outcomes of the Retrograde Femoral Nail-Advanced with Lateral Attachment Washer (RFNA-LAW) (Synthes, Paoli, PA) compared with laterally locked plates (LLP) when treating AO/OTA type 33 distal femoral fractures.
Retrospective chart review.
Single, academic, Level-1 Trauma Center.
All adult patients who had fixation of an AO/OTA type 33 distal femoral fracture with the RFNA-LAW combination or LLP from 2018 to 2023 with follow-up to union or a minimum of 1 year.
The main outcome measure was union. Secondary outcomes included implant failure, infection, and alignment immediately postoperatively and at final follow-up. Primary and secondary outcome measures were compared between the RFNA-LAW and LLP groups.
Forty-eight patients (19 female) with a mean age of 56 years (range 19-94 years) were in the RFNA-LAW group. Fifty-three patients (29 female) with a mean age of 66 years (24-91 years) were in the LLP group. There were no significant differences when comparing body mass index, diabetes, smoking status, mechanism of injury, or fracture classification between groups ( P > 0.05). There was no difference in immediate, postoperative alignment ( P = 0.49). When comparing anatomic lateral distal femoral angle measurements at final follow-up, there was significantly more malalignment in the LLP group ( P = 0.005). There were 8 implant failures (15%) in the LLP group compared with 1 in the RFNA-LAW group (2%) ( P = 0.02). There were 14 reoperations (26%) in the LLP group compared with 4 (8%) in the RFNA-LAW group ( P = 0.02).
The Retrograde Nail Advanced-Lateral Attachment Washer combination demonstrated a high union rate when treating complex fractures of the distal femur. When compared with lateral locked plating, this implant combination demonstrated significantly lower rates of nonunion and reoperation.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
本研究旨在报告逆行股骨钉-高级与侧附接垫圈（RFNA-LAW）（Synthes，Paoli，PA）治疗 AO/OTA 33 型股骨远端骨折的结果与外侧锁定板（LLP）相比。
回顾性图表审查。
单一的、学术的、一级创伤中心。
所有在 2018 年至 2023 年间接受 RFNA-LAW 联合或 LLP 固定治疗 AO/OTA 33 型股骨远端骨折且随访至愈合或至少 1 年的成年患者。
RFNA-LAW 组有 48 例患者（19 例女性），平均年龄 56 岁（19-94 岁）。LLP 组有 53 例患者（29 例女性），平均年龄 66 岁（24-91 岁）。两组之间在体重指数、糖尿病、吸烟状态、损伤机制或骨折分类方面没有显著差异（P > 0.05）。即时、术后对线无差异（P = 0.49）。比较最终随访时解剖外侧远端股骨角测量值，LLP 组明显更对线不良（P = 0.005）。LLP 组有 8 例（15%）植入物失败，RFNA-LAW 组有 1 例（2%）（P = 0.02）。LLP 组有 14 例（26%）再手术，RFNA-LAW 组有 4 例（8%）（P = 0.02）。
逆行钉高级-侧附接垫圈组合在治疗复杂的股骨远端骨折时具有较高的愈合率。与外侧锁定板相比，这种植入物组合显示出明显较低的不愈合和再手术率。
治疗水平 III。请参阅作者说明以获取完整的证据水平描述。
