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Femoral biologic plate fixation
Costas Papakostidis1, Martin R W Grotz, George Papadokostakis
1Department of Trauma & Orthopaedics, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
Clinical Orthopaedics and Related Research
|May 17, 2006
Summary
Biologic plate fixation, a modern approach to femoral fracture treatment, demonstrates a high union rate (98.4%) and low infection rate (2%). This technique is a viable alternative for complex fractures, especially in polytrauma patients.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Biomedical engineering
Background:
- Traditional mechanical stabilization methods for femoral fractures are being superseded by techniques emphasizing indirect reduction, meticulous soft tissue management, and elastic fixation.
- These advancements have led to the development and adoption of biologic plate fixation strategies.
Purpose of the Study:
- To systematically review and evaluate the efficacy of femoral biologic plate fixation in fracture treatment.
- To analyze union rates, complication profiles, and outcomes associated with this surgical approach.
Main Methods:
- Systematic literature review of 19 studies involving 687 patients and 697 femoral fractures.
- Analysis included fracture types (subtrochanteric, diaphyseal, supracondylar), fracture severity (open, comminuted, AO Types B & C), and treatment outcomes.
Main Results:
- An overall union rate of 98.4% was observed, with mean union times ranging from 10.7 to 24 weeks.
- Complications included malunion (0-29%) and reoperation (0-23%). Bone grafting was required in a significant portion of cases (0-55%).
- The infection rate was low at 2%.
Conclusions:
- Biologic plate fixation achieves high union rates and low infection rates, presenting a promising alternative to traditional nailing techniques.
- This method is particularly suitable for complex femoral fractures, including those in patients with polytrauma.
- While effective, the occasional need for bone grafting should be considered in treatment planning.