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- Talk
- 15/09/2021
- Canada
Epiphyseal Medialization following Distal Femur Plating is Associated with Revision Surgery
Description
Philippe Beauchamp-Chalifour, a resident at Laval University, presents his research on the risk factors associated with revision surgery following distal femur plating. He highlights that the rate of non-union after plate fixation for distal femur fractures is alarmingly high, with obesity, smoking, open fractures, the material of the plates, and infections being prominent risk factors. Beauchamp-Chalifour discusses the complications related to anatomical plates that may not conform well to patient anatomy, notably leading to the Golf-Club deformity, which is believed to correlate with mechanical failure despite lacking robust clinical evidence.
The study conducted was a retrospective cohort analysis spanning ten years, including patients aged 18 and older who underwent surgery with lateral distal femur locking plates. Exclusions were made for cases involving infection or significant bone loss. The research aimed to ascertain whether medialization of the distal femoral epiphysis related to revision surgery outcomes.
The cohort comprised 96 patients averaging 61 years, predominantly female, with a follow-up period of two years. Out of these, 13 patients underwent revision surgery—several due to non-union and implant failures. Notably, younger, heavier male patients with open fractures showed a greater risk for revision, while epiphyseal medialization was significantly linked to these outcomes.
Specifically, those in the revision group displayed an average medialization of 9.5 millimeters compared to 2.3 millimeters in those not requiring revision. Various surgical factors did not appear to correlate with revision rates, but in a multivariate model, open fractures and significant medialization did represent important risk factors. Beauchamp-Chalifour concludes that medialization exceeding 5 millimeters is associated with increased revision rates and urges caution in surgical technique when employing anatomical plates.