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Early Mechanical Failures of the Synthes Variable Angle Locking Distal Femur Plate.
Tank, Jason C; Schneider, Prism S; Davis, Elizabeth; Galpin, Matthew; Prasarn, Mark L; Choo, Andrew M; Munz, John W; Achor, Timothy S; Kellam, James F; Gary, Joshua L.
Afiliación
  • Tank JC; Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX.
J Orthop Trauma ; 30(1): e7-e11, 2016 Jan.
Article en En | MEDLINE | ID: mdl-26849390
OBJECTIVES: To document the high failure rate of a specific implant: the Synthes Variable Angle (VA) Locking Distal Femur Plate. DESIGN: Retrospective. SETTING: Urban University Level I Trauma Center. PATIENT/PARTICIPANTS: All distal femur fractures (OTA/AO 33-A, B, C) treated from March 2011 through August 2013 were reviewed from our institutional orthopaedic trauma registry. Inclusion criteria were fractures treated with a precontoured distal femoral locking plate and age between 18 and 84. Exclusion criteria were fractures treated with intramedullary nails, arthroplasty, non-precontoured plates, dual plating, or screw fixation alone. The population was divided into 3 groups: less invasive stabilization system (LISS) group (n = 21), treated with LISS plates (Synthes, Paoli, PA); locking condylar plates (LCPs) group (n = 10), treated with LCPs (Synthes, Paoli, PA); and VA group (n = 36), treated with VA distal femoral LCPs (Synthes, Paoli, PA). Average age was 54.6 ± 17.5 years. INTERVENTION: Open reduction internal fixation with one of the above implants was performed. MAIN OUTCOME MEASURES: The patients were followed radiographically for early mechanical implant failure defined as loosening of locking screws, loss of fixation, plate bending, or implant failure. RESULTS: There were no statistically significant differences between groups for age, gender, open fracture, mechanism of injury, or medial comminution. There were 3 failures (14.3%) in group LISS, no failures (0%) in group LCP, and 8 failures (22.2%) in group VA. All 3 failures in group LISS were in A-type fractures (2 periprosthetic) and all failures in group VA were in C-type fractures. When all fractures for all 3 groups were compared for failure rate, there was no statistically significant difference (P = 0.23). However, when only 33-C fractures were compared, there was significantly greater failure rate in the VA group (P = 0.03). The mean time to failure in group VA was 147 days (range 24-401 days) and was significantly earlier (P = 0.034) when compared with group LISS (mean 356 days; range 251-433 days). CONCLUSIONS: Early mechanical failure with the VA distal femoral locking plate is higher than traditional locking plates (LCP and LISS) for OTA/AO 33-C fractures. We caution practicing surgeons against the use of this plate for metaphyseal fragmented distal femur fractures. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placas Óseas / Falla de Equipo / Fracturas del Fémur / Fijación Interna de Fracturas Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placas Óseas / Falla de Equipo / Fracturas del Fémur / Fijación Interna de Fracturas Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos