COMPARATIVE STUDY
JOURNAL ARTICLE
MULTICENTER STUDY

Stabilization of distal femur fractures with intramedullary nails and locking plates: differences in callus formation

Christopher E Henderson, Trevor Lujan, Michael Bottlang, Daniel C Fitzpatrick, Steve M Madey, J Lawrence Marsh
Iowa Orthopaedic Journal 2010, 30: 61-8
21045973

OBJECTIVES: This study compared callus formation in distal femur fractures stabilized with locking plates and intramedullary nails to test the hypothesis that locking plates induce less fracture callus than IM nails.

DESIGN: Retrospective case matched study.

SETTING: Two orthopaedic trauma centers.

PATIENTS: 174 distal femur fracture were reviewed to extract cases treated with retrograde IM nails (NAIL group, n = 12). These were then individually matched to cases treated with locking plates (Plate group, n = 12).

INTERVENTION: Retrograde IM nailing or locking plate fracture fixation.

OUTCOME MEASURES: Periosteal callus was measured on lateral and antero-posterior radiographs taken at 12 weeks after injury using validated software to objectively extract the size of peripheral callus from digital radiographs.

RESULTS: The NAIL group had 2.4 times more callus area per location (231 ± 304 mm(2)) than the PLATE group (95 ± 109 mm(2), p=0.028). Compared to the PLATE group, the NAIL group had 3.4 times more callus anteriorly (p=0.31), 2.6 times more callus posteriorly (p=0.25), and 2.3 times more callus medially (p=0.16). At 12 weeks after injury, no or minimal callus for secondary bone healing (<20 mm(2)) was present in 20% of callus locations in the NAIL group and in 54% of callus locations in the PLATE group.

CONCLUSION: Significantly less periosteal callus formed in fractures stabilized with locking plates than with IM nails. This result is likely multifactorial and further study of the interaction between construct stiffness and fracture healing in the distal femur is warranted.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
21045973
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"