TY - JOUR
T1 - Modified use of the proximal humeral internal locking system (PHILOS) plate for distal femoral nonunions
AU - Poelmann, Josje
AU - Kloen, Peter
N1 - Publisher Copyright: © 2022, The Author(s).
PY - 2023
Y1 - 2023
N2 - Purpose: Nonunion is a common complication after a distal femoral fracture (DFF). Standard treatment consists of revision plating and/or bone grafting. Single lateral plating for a distal femoral nonunion can be insufficient in case of a persistent medial gap and compromised bone stock. Alternatively, dual plating can be used to treat a distal femoral nonunion, but to date there is no Gold standard. The aim of our study was to report our results after use of a minimally invasively placed proximal humeral internal locking system (Philos) plate as a medial buttress in the treatment of a distal femoral nonunion. Methods: Fifteen adult patients with a distal femoral nonunion were prospectively entered in a trauma database and retrospectively assessed. All patients underwent a similar operation, which included removal of failed hardware, nonunion debridement, fixation with a lateral plate, and a medial Philos plate combined with bone grafting. Data collected included union rate, time to union, complications and functional outcome. Results: In twelve out of fifteen patients (80%), the fracture united after our index operation. Median time to union was 4.8 months (range 1.6–15). Three patients (20%) needed additional bone grafting surgery. One patient underwent a Judet quadricepsplasty. Conclusion: This study suggests that the Philos plate is a safe and effective adjunct as a medial buttress plate for distal femoral nonunions.
AB - Purpose: Nonunion is a common complication after a distal femoral fracture (DFF). Standard treatment consists of revision plating and/or bone grafting. Single lateral plating for a distal femoral nonunion can be insufficient in case of a persistent medial gap and compromised bone stock. Alternatively, dual plating can be used to treat a distal femoral nonunion, but to date there is no Gold standard. The aim of our study was to report our results after use of a minimally invasively placed proximal humeral internal locking system (Philos) plate as a medial buttress in the treatment of a distal femoral nonunion. Methods: Fifteen adult patients with a distal femoral nonunion were prospectively entered in a trauma database and retrospectively assessed. All patients underwent a similar operation, which included removal of failed hardware, nonunion debridement, fixation with a lateral plate, and a medial Philos plate combined with bone grafting. Data collected included union rate, time to union, complications and functional outcome. Results: In twelve out of fifteen patients (80%), the fracture united after our index operation. Median time to union was 4.8 months (range 1.6–15). Three patients (20%) needed additional bone grafting surgery. One patient underwent a Judet quadricepsplasty. Conclusion: This study suggests that the Philos plate is a safe and effective adjunct as a medial buttress plate for distal femoral nonunions.
KW - Distal femoral fracture
KW - Dual Plating
KW - Nonunion
KW - Philos
UR - http://www.scopus.com/inward/record.url?scp=85123254102&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00590-022-03203-4
DO - https://doi.org/10.1007/s00590-022-03203-4
M3 - Article
C2 - 35061100
SN - 1633-8065
JO - European journal of orthopaedic surgery and traumatology
JF - European journal of orthopaedic surgery and traumatology
ER -