[Corrective osteotomy of post-traumatic malunions and pseudarthroses in the femur using a fork plate: a prospective analysis of 23 consecutive cases].
BACKGROUND
The fork plate is a further development of the AO fixed-angle blade plate, which facilitates the seeding of the angle blade. In a prospective study we evaluated the applicability of the fork plate for the correction of post-traumatic malunions and pseudarthroses in the femur.


METHODS
Between 01/1993 and 12/2003 a consecutive series of 23 patients were operated due to post-traumatic malunion or pseudarthrosis of the femur with an average age of 46 years at the time of surgery. The operative procedure is analogous to the one using angle blade plates. The most important surgical step, the placement of the fork instead of the blade, is more precise thanks to stepwise control with the image intensifier.


RESULTS
All preexisting malunions and pseudarthroses were corrected with the fork plate as preoperatively planned. Complications not related to the implant were found in 13%, all of which resolved without sequelae. In 87% we found a bony union of the osteotomy after 3 months, and the three remaining femora healed within an additional 2-12 months without loss of the correction achieved.


CONCLUSIONS
In all of the cases analyzed, the fork plate proved to be of value for correction of femoral malunion and pseudarthrosis. In relation to the angle blade plate, the fork plate features a modified surgical technique with the same possible indications. As a consequence this modification provides a high level of therapeutic safety even with a small number of annual operations performed.
Clauss
M
M
Abteilung für Orthopädie und Traumatologie, Kantonsspital, Rheinstrasse 26, CH-4410 Liestal, Switzerland. martin.clauss@ksli.ch
Ilchmann
T
T
Zimmermann
P
P
Ochsner
P E
PE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012086:Reoperation