Abstract
BackgroundTo analyze the risk factors of revision operation after the treatment of distal femoral fracture with lateral locking plate (LLP).MethodsRetrospective analysis of the clinical data of 152 cases with distal femoral fracture treated in our hospital from March 2005 to March 2019. The SPSS 26.0 software (univariate analysis and logistic regression analysis) was used to analyze the general condition, fracture-related factors, operation-related factors, and construct characteristics of internal fixation.ResultsSixteen of 152 patients who were included in the study underwent revision surgery, with a revision rate 10.5%. Univariate analysis showed that there were significant differences in age, body mass index (BMI), fracture type, supracondylar involved or not, type of incision, quality of reduction, ratio of length of plate/fracture area (R1), the ratio of the length of the plate/fracture area above the condylar (R2), ratio of distance between proximal part of fracture and screw/working length of proximal plate (R3) between the two groups (P < 0.05). Logistic regression analysis showed that age [OR for age > 61.5 group is 4.900 (1.071–22.414)], fracture type [OR for A3 fracture is 8.572 (1.606–45.750), the OR for periprosthetic fracture after TKA is 9.073 (1.220–67.506)], poor reduction quality [OR is 7.663 (1.821–32.253)], and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors (P < 0.05).ConclusionAge, fracture type (A3 and periprosthetic fracture after TKA), poor reduction quality, and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors of the revision in distal femoral fractures treated with lateral locking plate. The appropriate application of the locking plate and operation strategy are the key to reduce the revision rate in distal femoral fractures.
Highlights
To analyze the risk factors of revision operation after the treatment of distal femoral fracture with lateral locking plate (LLP)
With the accumulation of cases, initial success rates of the treatment of distal femoral fractures with LLP have given way to high incidence of complications 32%, such as delayed union, nonunion, and failure of internal fixation, among which the incidence of nonunion could be as high as 0–21% [4, 5]
16 fractures were surgically revised for nonunion, with a revision rate 10.5%
Summary
To analyze the risk factors of revision operation after the treatment of distal femoral fracture with lateral locking plate (LLP). With the accumulation of cases, initial success rates of the treatment of distal femoral fractures with LLP have given way to high incidence of complications 32%, such as delayed union, nonunion, and failure of internal fixation, among which the incidence of nonunion could be as high as 0–21% [4, 5]. This increase may be multifactorial and attributable to an increased use of the technique, which is an application to a broader range of patient types. Distal femoral nonunions are disastrous and associated with axial malalignment, chronic pain, loss of ambulatory function, and decreased knee range of motion (ROM) [6]
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