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Title: Non-union in lateral locked plating for distal femoral fractures: A systematic review.
Austin Authors: Wang, Michael Tianfeng;An, Vincent V G;Sivakumar, Brahman Shankar
Affiliation: Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
Department of Surgery, Royal Prince Alfred Hospital, Australia
Faculty of Medicine and Health, Sydney University, New South Wales, Australia
Department of Hand Surgery & Microsurgery, Liverpool & Fairfield Hospitals, New South Wales, Australia
Issue Date: Nov-2019 2019-07-13
Publication information: Injury 2019; 50(11): 1790-1794
Abstract: This study aims to identify patient and intra-operative factors that contribute to non-union in locked lateral plating for distal femoral fractures. Systematic searches of English-language articles in Ovid Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were undertaken in February 2018 according to the PRISMA guidelines. The search terms were (fracture or fracture*) AND (distal femur or distal femoral) AND (malunion or non-union). Eligible studies published at any time reported non-union rates and compared patient and intraoperative factors in patients who underwent locked lateral plating for traumatic distal femoral fractures. The quality of included papers was assessed using The Journal of Bone and Joint Surgery levels of evidence (Wright et al., 2003), and further appraised using the Downs and Black score (Downs and Black, 1998). Eight studies investigating 1380 distal femoral fractures were found to satisfy the inclusion and exclusion criteria. These studies analysed a variety of patient and intra-operative factors that may contribute to non-union. These include high BMI, open fracture, comminution, fracture infection, stainless steel plate material, shorter working length, open reduction and internal fixation when compared with minimally invasive plate osteosynthesis, high construct rigidity scores and purely locking screw constructs. This review has identified multiple factors which potentially contribute to non-union including stainless steel plate material, high construct rigidity scores and purely locking screw constructs. These findings may reflect that overly rigid plating constructs can contribute to non-union. However, they should be taken in the context of heterogeneity amongst included studies, with further research necessary to support these findings.
DOI: 10.1016/j.injury.2019.07.012
PubMed URL: 31324342
Type: Journal Article
Subjects: Distal femur
Lateral locked plating
Locked plate
Appears in Collections:Journal articles

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