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VOLUME 17 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

The Management of Aseptic Non-unions of Distal Femur Fractures with Anatomical Lateral Locking Plates

John Mukhopadhaya, Rajeev Ranjan, Amit Kumar Sinha, Janki Sharan Bhadani

Keywords : Aseptic non-union, Autologous bone grafting, Compression device, Decortication, Distal femur fracture, Distal femur locking plate, Lateral locking plate, Non-union

Citation Information : Mukhopadhaya J, Ranjan R, Sinha AK, Bhadani JS. The Management of Aseptic Non-unions of Distal Femur Fractures with Anatomical Lateral Locking Plates. 2022; 17 (3):137-143.

DOI: 10.5005/jp-journals-10080-1564

License: CC BY-NC-SA 4.0

Published Online: 30-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: Distal femoral non-unions are challenging, and frequently associated with short distal fragments, poor bone stock, and with issues from previous implants. Materials and methods: A retrospective study of 31 patients admitted with distal femoral non-unions treated using anatomical lateral locking plates. Non-union scores were used. The Knee Society and Neer’s scores were used for the comparison of results. The mean follow-up was 39.5 months (from 24 months to 60 months). Results: Stable union was accomplished in all. There was a significant improvement in the average Neer’s score (24 preoperative to 82 post-operatively at final follow-up), the Part 1 Knee Society score from an average of 46 preoperatively to 84 post-operatively, and Part 2 Knee Society score from 36 preoperatively to 80 post-operatively. Conclusion: Optimal stability, good compression at the non-union site (either by lag screws or a compression device or both), maintaining the axial alignment strictly, freshening of bone ends, using an adequate amount of cortico-cancellous bone graft, respecting the biology along with the correct choice of the implant (including the size) are essential to achieve union at the fracture site. Clinical significance: Paying attention to the basic principles of management, good contact, stability and maintaining biology is essential in the treatment of non-union.

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