Skip to main content
SpringerLink
Log in

Plate-on-plate technique for treating peri-implant fractures of distal femoral locking plate: a retrospective study of 11 patients

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In this study, we aimed to ascertain the feasibility and reliability of the plate-on-plate technique for peri-implant fractures of the distal femoral locking plate when the distal femoral fracture is still unhealed.

Materials and methods

From January 2007 to December 2016, we enrolled 11 patients who received treatment at our institution. All patients underwent at least 1 year of follow-up. Their medical records, imaging studies, visual analogue scores, walking ability, complications, and functional outcomes at 1 year postoperative based on the Short Form (36) Health Survey (SF-36) scores were retrospectively evaluated.

Results

The average follow-up duration was 20.5 (range 15–30) months. All fractures united with satisfactory alignment, and the average time for union was 27.5 (range 16–40) weeks. The average SF-36 scores at 1 year postoperative was 79.2 (range 72–90). Regarding ambulatory status, all patients could perform unrestricted outdoor ambulation.

Conclusion

In our case series, the plate-on-plate technique achieved a good bone union rate and functional outcomes with low complication rates and thus may be a good alternative for managing this difficult type of fracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Martinet O, Cordey J, Harder Y, Maier A, Bühler M, Barraud GE (2000) The epidemiology of fractures of the distal femur. Injury 31:62–63

    Article  Google Scholar 

  2. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697

    Article  Google Scholar 

  3. Smith TO, Hedges C, MacNair R, Schankat K, Wimhurst JA (2009) The clinical and radiological outcomes of the LISS plate for distal femoral fractures: a systematic review. Injury 40:1049–1063

    Article  CAS  PubMed  Google Scholar 

  4. Ruchholtz S, El-Zayat B, Kreslo D, Bucking B, Lewan U, Kruger A et al (2013) Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur—a prospective study of 41 patients. Injury 44:239–248

    Article  PubMed  Google Scholar 

  5. Ricci AR, Yue JJ, Taffet R, Catalano JB, DeFalco RA, Wilkens KJ (2004) Less invasive stabilization system for treatment of distal femur fractures. Am J Orthop 33:250–255

    PubMed  Google Scholar 

  6. Wilkens KJ, Curtiss S, Lee MA (2008) Polyaxial locking plate fixation in distal femur fractures: a biomechanical comparison. J Orthop Trauma 22:624–628

    Article  Google Scholar 

  7. Button G, Wolinsky P, Hak D (2004) Failure of less invasive stabilization system plates in the distal femur: a report of four cases. J Orthop Trauma 18:565–570

    Article  PubMed  Google Scholar 

  8. Henderson CE, Kuhl LL, Fitzpatrick DC, Marsh JL (2011) Locking plates for distal femur fractures: is there a problem with fracture healing? J Orthop Trauma 25:8–14

    Article  Google Scholar 

  9. Ricci WM, Streubel PN, Morshed S, Collinge CA, Nork SE, Gardner MJ (2014) Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases. J Orthop Trauma 28:83–89

    Article  Google Scholar 

  10. Lujan TJ, Henderson CE, Madley SM, Fitzpatrick DC, MarshJL Bottlang M (2010) Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma 24:156–162

    Article  PubMed  Google Scholar 

  11. Park KC, Lim SJ, Song YS, Hwang KT (2017) Factors affecting peri-implant fracture following locking plate for osteoporotic distal femur fractures. Orthop Traumatol Surg Res 103:1201–1204

    Article  PubMed  Google Scholar 

  12. Chan LWM, Gardner AW, Wong MK, Chua K, Kwek EBK, Singapore Orthopaedic Research CollaborativE (SORCE) (2018) Non-prosthetic peri-implant fractures: classification, management and outcomes. Arch Orthop Trauma Surg 138(6):791–802

    Article  PubMed  Google Scholar 

  13. Mueller M, Nazarian S, Koch P, Schatzker J (1990) The comprehensive classification of fractures of long bones. Springer, Berlin

    Book  Google Scholar 

  14. Bromm B (1985) Pain measurement in man: neurophysiological correlates of pain. J Neurol Sci 70:113

    Google Scholar 

  15. Syddall HE, Martin HJ, Harwood RH, Cooper C, Aihie Sayer A (2009) The SF-36: a simple, effective measure of mobility-disability for epidemiological studies. J Nutr Health Aging 13:57–62

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Krause FG, Aebi H, Lehmann O, Weber M (2007) The “flap-shaft” prosthesis for insensate feet with Chopart or Lisfranc amputations. Foot Ankle Int 28:255–262

    Article  PubMed  Google Scholar 

  17. Forster MC, Komarsamy B, Davison JN (2006) Distal femoral fractures: a review of fixation methods. Injury 37:97–108

    Article  CAS  PubMed  Google Scholar 

  18. Heiney JP, Barnett MD, Vrabec GA, Schoenfeld AJ, Baji A, Njus GO (2009) Distal femoral fixation: a biomechanical comparison of trigen retrograde intramedullary (i.m.) nail, dynamic condylar screw (DCS), and locking compression plate (LCP) condylar plate. J Trauma 66:443–449

    Article  PubMed  Google Scholar 

  19. Ma CH, Tu YK, Yu SW, Yen CY, Yeh JH, Wu CH (2010) Reverse LISS plates for unstable proximal femoral fractures. Injury 41:827–833

    Article  PubMed  Google Scholar 

  20. Marti A, Fankhauser C, Frenk A, Cordey J, Gasser B (2001) Biomechanical evaluation of the less invasive stabilization system for the internal fixation of distal femur fractures. J Orthop Trauma 15:482–487

    Article  CAS  PubMed  Google Scholar 

  21. Sah AP, Marshall A, Virkus WV, Estok DM II, Della Valle CJ (2010) Interprosthetic fractures of the femur: treatment with a single-locked plate. J Arthroplast 25:280–286

    Article  Google Scholar 

  22. Mamczak CN, Gardner MJ, Bolhofner B, Borrelli J Jr, Streubel PN, Ricci WM (2010) Interprosthetic femoral fractures. J Orthop Trauma 24:740–744

    Article  PubMed  Google Scholar 

  23. Schiuma D, Plecko M, Kloub M, Rothstock S, Windolf M, Gueorguiev B (2013) Influence of periimplant bone quality on implant stability. Med Eng Phys 35:82–87

    Article  PubMed  Google Scholar 

  24. Bottlang M, Doornink J, Byrd GD, Fitzpatrick DC, Madey SM (2009) A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg Am 91:620–627

    Article  PubMed  Google Scholar 

  25. Sommer C, Gautier E, Muller M, Helfet DL, Wagner M (2003) First clinical results of the locking compression plate (LCP). Injury 34:43–54

    Article  Google Scholar 

  26. Cheal EJ, Hayes WC, White AA 3rd, Perren SM (1985) Stress analysis of compression plate fixation and its effects on long bone remodeling. J Biomech 18:141–150

    Article  CAS  PubMed  Google Scholar 

  27. Davenport SR, Lindsey RW, Leggon R, Miclau T, Panjabi M (1988) Dynamic compression plate fixation: a biomechanical comparison of unicortical vs bicortical distal screw fixation. J Orthop Trauma 2:146–150

    Article  CAS  PubMed  Google Scholar 

  28. el Moumni M, Voogd EH, ten Duis HJ, Wendt KW (2012) Long-term functional outcome following intramedullary nailing of femoral shaft fractures. Injury 43:1154–1158

    Article  PubMed  Google Scholar 

  29. Ebraheim NA, Gomez C, Ramineni SK, Liu J (2009) Fixation of periprosthetic femoral shaft fractures adjacent to a well-fixed femoral stem with reversed distal femoral locking plate. J Trauma 4:1152–1157

    Article  Google Scholar 

  30. Ahmad M, Nanda R, Bajwa AS, Candal-Coutou J, GreenS Hui AC (2007) Biomechanical testing of the locking compression plate: when does the distance between bone and implant significantly reduce construct stability? Injury 38:358–364

    Article  CAS  Google Scholar 

  31. Ma CH, Wu CH, Tu YK, Lin TS (2013) Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures—clinical outcome and a finite element study. Injury 44:1097–1101

    Article  PubMed  Google Scholar 

  32. Ma C-H, Wu CH, Jiang JR, Tu YK, Lin TS (2017) Metaphyseal locking plate as an external fixator for open tibial fracture: clinical outcomes and biomechanical assessment. Injury 48:501–505

    Article  PubMed  Google Scholar 

  33. Serhan H, Slivka M, Albert T, Kwak SD (2004) Is galvanic corrosion between titanium alloy and stainless steel spinal implants a clinical concern? Spine J 4:379–387

    Article  PubMed  Google Scholar 

  34. Venugopalan R, Lucas LC (1998) Evaluation of restorative and implant alloys galvanically coupled to titanium. Dent Mater 14:165–172

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all patients for participating in the study and Editage Company for the English editing.

Funding

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Author information

Author notes

  1. Ching-Hou Ma and Yen-Chun Chiu contributed to this paper equally.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, E-Da Hospital, I-Shou University, 1, E-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, 824, Kaohsiung, Taiwan, ROC

    Ching-Hou Ma, Yen-Chun Chiu, Chin-Hsien Wu, I-Ming Jou & Yuan-Kun Tu

  2. Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Kun-Ling Tsai

  3. Department of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan

    Tsung-Kai Wen

Authors
  1. Ching-Hou Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yen-Chun Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chin-Hsien Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kun-Ling Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tsung-Kai Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. I-Ming Jou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuan-Kun Tu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuan-Kun Tu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ma, CH., Chiu, YC., Wu, CH. et al. Plate-on-plate technique for treating peri-implant fractures of distal femoral locking plate: a retrospective study of 11 patients. Arch Orthop Trauma Surg 139, 1245–1251 (2019). https://doi.org/10.1007/s00402-019-03185-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-019-03185-9

Keywords

Search

Navigation