Dynamic fixation of distal femur fractures using far cortical locking screws: a prospective observational study.
OBJECTIVE
Document fixation and healing of distal femur fractures stabilized by plate osteosynthesis using far cortical locking (FCL) screws.


METHODS
Prospective and observational.


METHODS
Two level 1 and 1 level 2 trauma centers.


METHODS
Thirty-two consecutive patients with 33 distal femur fractures (AO/OTA types 33A, 33C).


METHODS
Fractures were stabilized by plate osteosynthesis with MotionLoc FCL screws without supplemental bone graft or bone morphogenic proteins. Patients were followed up for a minimum of 1 year with functional and radiographic assessments obtained at postoperative weeks 6, 12, and 24 and computed tomography scans at week 12. If union was not confirmed within 1 year, follow-up was continued until union or revision surgery.


METHODS
The primary end point was fracture union in the absence of complications and secondary interventions. Fracture healing was defined by resolution of pain at the fracture site and cortical bridging on biplanar radiographs. Complications were defined by fixation failure, loss of reduction, implant breakage, infection, nonunion, and need for revision.


RESULTS
Thirty-one fractures were available for follow-up. None of the 125 FCL screws used for diaphyseal fixation broke or lost fixation. One of the 31 fractures displaced into varus (ΔVarus = 5.8 degrees). Thirty of the 31 fractures healed within 15.6 ± 6.2 weeks. At an average follow-up of 17 ± 4 months, there were 2 revisions: one to correct a malrotation at day 5 and one to treat a nonunion at 6 months.


CONCLUSIONS
Absence of implant and fixation failure suggests that dynamic plating of distal femur fractures with FCL screws provides safe and effective fixation.
*Legacy Research Institute, Portland, OR; †Slocum Center for Orthopedics, Eugene, OR; and ‡University of Utah Orthopaedic Center, Salt Lake City, UT.
Michael
M
Bottlang
Daniel C
DC
Fitzpatrick
Dan
D
Sheerin
Erik
E
Kubiak
Richard
R
Gellman
Corey
C
Vande Zandschulp
Josef
J
Doornink
Kathleen
K
Earley
Steven M
SM
Madey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D055815:Young Adult