دورية أكاديمية
أعرض في EDS

Outcomes of Distal Third Femur Fractures in Patients 18 Years and Older: A Pilot Study.

التفاصيل البيبلوغرافية
العنوان: Outcomes of Distal Third Femur Fractures in Patients 18 Years and Older: A Pilot Study.
المؤلفون: Roytman GR; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Jabbouri SS; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., O'Marr J; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Raghuram A; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Beitler B; Orthopaedics, Mount Sinai Hospital, New Haven, USA., Irshad S; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Fram BR; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Yoo BJ; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Leslie MP; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Riedel MD; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Tommasini SM; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA., Wiznia DH; Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, USA.
المصدر: Cureus [Cureus] 2024 Feb 28; Vol. 16 (2), pp. e55136. Date of Electronic Publication: 2024 Feb 28 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Introduction: The selection of the most optimal fixation method for fractures of the distal femur, whether intramedullary nail (NL), lateral locking plate (PL), or nail/plate (NP) is not always clear. This study retrospectively evaluates surgical patients with distal femur fractures and introduces a pilot study using cluster analysis to identify the most optimal fracture fixation method for a given fracture type.
Methods: This is a retrospective cohort study of patients 18 years and older with an isolated distal femur fracture who presented to our Level-1 trauma center between January 1, 2012, and December 31, 2022, and obtained NL, PL, or NP implants. Patients with polytrauma and those without at least six months of follow-up were excluded. A chart review was used to obtain demographics, fracture classification, fixation method, and postoperative complications. A cluster analysis was performed. The following factors were used to determine a successful outcome: ambulatory status pre-injury and 6-12 months postoperatively, infection, non-union, mortality, and implant failure.
Results: A total of 169 patients met inclusion criteria. No statistically significant association between the fracture classification and fixation type with overall outcome was found. However, patients treated with an NP (n = 14) had a success rate of 92.9% vs only a 68.1% success rate in those treated with a PL (n = 116) (p = 0.106). The most notable findings in the cluster analysis (15 total clusters) included transverse extraarticular fractures demonstrating 100% success if treated with NP (n = 6), 50% success with NL (n=2), and 78.57% success with PL fixation (n=14). NP constructs in complete articular fractures demonstrated success in 100% of patients (n = 5), whereas 77.78% of patients treated with NL (n = 9) and 61.36% of those treated with PL (n = 44).
Conclusions: Plate fixation was the predominant fixation method used for distal third femur fractures regardless of fracture classification. However, NP constructs trended towards improved success rates, especially in complete intraarticular and transverse extraarticular fractures, suggesting the potential benefit of additional fixation with these fractures. Cluster analysis provided a heuristic way of creating patient profiles in patients with distal third femur fractures. However, a larger cohort study is needed to corroborate these findings to ultimately develop a clinical decision-making tool that also accounts for patient specific characteristics.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Roytman et al.)
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فهرسة مساهمة: Keywords: cluster analysis; demography; distal femur fractures; dual plate construct; lateral locking plate; outcome assessment; retrograde intramedullary femoral nail
تواريخ الأحداث: Date Created: 20240401 Latest Revision: 20240403
رمز التحديث: 20240403
مُعرف محوري في PubMed: PMC10979706
DOI: 10.7759/cureus.55136
PMID: 38558586
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.55136