Orthopedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
Orthopedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
BMJ Case Rep. 2024 Oct 8;17(10):e258919. doi: 10.1136/bcr-2023-258919.
Distal femoral fractures (DFFs) are frequently characterised by significant comminution, osteoporosis, high implant failure, insufficient fixation because of a shortened distal part, non-union, malunion, and poor outcome. Our report presents two cases treated with dual plating in a 90-90 construct to achieve torsional stability. DFF fixation by dual plating in a 90-90 configuration proved to be a superior fixation similar to 90-90 plating for distal humerus fracture, since 90-90 plate fixation had significantly greater torque to failure load and has more resistance to torsional loading. Two cases of distal femur non-union with implant failure were treated utilising a double plating. These non-union cases exhibited radiological healing and knee range of motion at a mean follow-up of 6 months. This technique offers a modified way of treating these difficult non-union cases through a single incision, providing mechanical stability conducive to fracture healing.
股骨远端骨折（DFF）常表现为严重粉碎、骨质疏松、高植入物失败率、因远端部分缩短而导致固定不足、不愈合、畸形愈合和预后不良。我们报告了两例采用 90-90 双钢板构建以实现扭转稳定性治疗的病例。通过 90-90 构型的双钢板固定 DFF 被证明是一种优越的固定方式，类似于 90-90 钢板固定治疗肱骨远端骨折，因为 90-90 钢板固定具有显著更高的失效扭矩和更强的抗扭转能力。两例存在植入物失败的股骨远端骨不连病例采用双钢板治疗。这些骨不连病例在平均 6 个月的随访时表现出影像学愈合和膝关节活动范围。该技术提供了一种通过单一切口治疗这些困难骨不连病例的改良方法，提供了有利于骨折愈合的机械稳定性。
