Weight-bearing as tolerated following distal femur fracture surgically treated with Far Cortical Locking screws

D. Fitzpatrick, Stephanie Mueller, Ellie Jitto, M. M. Herbert, Connor M Fitzpatrick, E. Owen
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Abstract

To review outcomes of a consecutive, non-selected series of distal femur fractures treated with a dynamic plate construct and allowed unrestricted weight bearing immediately after surgery. Retrospective consecutive case series. Level 2 trauma center Thirty-one consecutive distal femur fractures in 29 patients with 33A and 33C fractures stabilized with a distal femur locking plate and Far Cortical Locking diaphyseal screws. All patients were allowed immediate unrestricted weight bearing with assistive devices post-surgery. Loss of reduction from immediate post-operative alignment, implant failure, nonunion, and medical complications. No loss of alignment greater than three degrees in the lateral distal femoral angle was noted at healing. Two implant failures occurred, one in the first five weeks and another in an established nonunion. Mortality at one year was 6.5%. Readmission for medical complications was noted in 6.5% of patients. Immediate, unrestricted weight bearing after fixation of 33A and 33C distal femur fractures with a dynamic plate construct may be safe, with a low risk of implant failure or loss of coronal plane alignment. Relative to historical reports, morbidity and mortality in our cohort were improved with early weight-bearing. Therapeutic Level IV, case series
远皮质锁定螺钉治疗股骨远端骨折后的负重耐受
回顾连续的、非选择的一系列股骨远端骨折,术后立即采用动态钢板结构治疗并允许无限制负重的结果。回顾性连续病例系列。29例33A和33C型骨折患者中31例连续股骨远端骨折采用股骨远端锁定钢板和远皮质锁定骨干螺钉稳定。所有患者术后均允许立即不受限制地使用辅助装置负重。术后立即对准、种植体失败、骨不连和医疗并发症导致复位损失。愈合时,股骨外侧远端角未见超过3度的对准损失。发生了两次植入失败,一次发生在前五周,另一次发生在已确定的骨不连。一年的死亡率为6.5%。6.5%的患者因医疗并发症再次入院。动态钢板固定33A和33C股骨远端骨折后立即无限制负重可能是安全的,植入物失败或冠状面对齐丢失的风险较低。与历史报告相比,我们队列中的发病率和死亡率随着早期负重而改善。治疗级别IV,病例系列
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