Steimle Jerrod, Lohmeyer Jaron L, Taylor Benjamin, DeGenova Daniel T
Orthopaedic Surgery, Kettering Health Network, Dayton, USA.
Orthopaedic Trauma, OhioHealth Grant Medical Center, Columbus, USA.
Cureus. 2025 Feb 5;17(2):e78538. doi: 10.7759/cureus.78538. eCollection 2025 Feb.
There exists controversy in the treatment of acute distal femur fractures as well as distal femur fracture nonunions. The objective of this study is to determine the clinical benefit of adjunctive medial plate application in the setting of acute distal femur fractures and distal femur fracture nonunions.
This is a retrospective comparative study at a Level 1 academic trauma center, including 104 patients treated for acute distal femur fractures and 23 patients treated for distal femur nonunions between 2015 and 2019. The study compared dual plate fixation to other methods of fixation.
In the acute fracture setting, the dual-plate construct had a shorter time to union (22.1 weeks vs. 29.5 weeks, p=0.1337) and a better union rate (100% vs. 73.6%, p=0.1848), though neither were statistically significant. Complication rates between dual plating and single lateral plating were similar (20% dual plate vs. 14.3% single lateral plate, p=0.7245). For femoral nonunions, both treatment groups achieved a 100% union rate. The time to union was slightly longer in patients treated with an adjunctive medial plate (35 weeks vs. 31 weeks, p=0.6207). However, medial adjunctive plating had a lower complication rate (0% vs. 26.7%, p=0.1081). Conclusion: Dual plating plays a valuable role in the management of acute distal femur fractures, as well as in the adjunctive medial plating of distal femur nonunions treated with a lateral plate construct. This approach is especially beneficial for cases with inadequate medial cortical support or a high risk of varus collapse.
急性股骨远端骨折以及股骨远端骨折不愈合的治疗存在争议。本研究的目的是确定在急性股骨远端骨折和股骨远端骨折不愈合情况下应用辅助内侧钢板的临床益处。
这是一项在一级学术创伤中心进行的回顾性对照研究，纳入了2015年至2019年间治疗的104例急性股骨远端骨折患者和23例股骨远端骨折不愈合患者。该研究将双钢板固定与其他固定方法进行了比较。
在急性骨折情况下，双钢板结构的愈合时间较短（22.1周对29.5周，p = 0.1337），愈合率更高（100%对73.6%，p = 0.1848），但两者均无统计学意义。双钢板固定组与单侧外侧钢板固定组的并发症发生率相似（双钢板固定组为20%，单侧外侧钢板固定组为14.3%，p = 0.7245）。对于股骨骨折不愈合，两个治疗组的愈合率均达到100%。应用辅助内侧钢板治疗的患者愈合时间略长（35周对31周，p = 0.6207）。然而，内侧辅助钢板固定的并发症发生率较低（0%对26.7%，p = 0.1081）。结论：双钢板固定在急性股骨远端骨折的治疗以及采用外侧钢板结构治疗的股骨远端骨折不愈合的辅助内侧钢板固定中发挥着重要作用。这种方法对于内侧皮质支撑不足或内翻塌陷风险高的病例尤其有益。
