| Title |
Addition of a Medial Locking Plate to an In Situ Lateral Locking Plate Results in Healing of Distal Femoral Nonunions
|
|---|---|
| Published in |
Clinical Orthopaedics & Related Research, January 2016
|
| DOI | 10.1007/s11999-016-4709-3 |
| Pubmed ID | |
| Authors |
Michael A. Holzman, Bryan D. Hanus, John W. Munz, Daniel P. O’Connor, Mark R. Brinker |
| Abstract |
Nonunion of the distal femur after lateral plating is associated with axial malalignment, chronic pain, loss of ambulatory function, and decreased knee ROM. The addition of a medial locking plate with autogenous bone grafting can provide greater stability to allow bone healing and may be used to achieve union in these challenging cases. We wished to determine (1) the proportion of patients who achieve radiographic signs of osseous union for distal femoral nonunions with an in situ lateral plate after treatment with addition of a medial locking plate and autogenous bone grafting, and (2) the frequency and types of complications associated with this treatment. Between 2007 and 2013, we treated 22 patients for 23 distal femoral nonunions, defined as an unhealed fracture with no radiographic signs of osseous union at a mean of 16 months (SD, 13 months) after injury. During that time, we used a treatment algorithm consisting of treatment in one or two stages. The single-stage procedure performed in 16 aseptic nonunions with a stable lateral plate involved addition of a medial locking plate and autogenous bone graft. A two-stage treatment performed in seven nonunions with lateral plate failure involved placement of a new lateral locking plate followed by addition of a medial locking plate with autogenous bone graft at least 2 months after the first procedure. Of the 22 patients treated, 20 had a median followup of 18 months (SD, 6-94 months). We defined osseous union by bridging bone on three of four cortices with absence of a radiolucent line or more than 25% cross-sectional area of bridging bone via CT. Twenty of the 21 nonunions attained radiographic signs of osseous union by 12 months. Six of the 20 patients experienced complications: one patient had a persistent nonunion; four patients underwent removal of symptomatic hardware; and one patient experienced skin breakdown at the bone graft harvest site. A very high proportion of patients achieve union when using medial locking plates to treat distal femoral nonunions after lateral plating of the original injury. Addition of bone graft, staged reconstruction, and revision of the initial lateral plate is indicated when the nonunion is associated with fatigue failure of the initial lateral plate. Level IV, therapeutic study. |
X Demographics
The data shown below were collected from the profiles of 17 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 35% |
| United Kingdom | 2 | 12% |
| Turkey | 1 | 6% |
| Spain | 1 | 6% |
| Venezuela, Bolivarian Republic of | 1 | 6% |
| Sweden | 1 | 6% |
| Canada | 1 | 6% |
| Pakistan | 1 | 6% |
| Mongolia | 1 | 6% |
| Other | 0 | 0% |
| Unknown | 2 | 12% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 47% |
| Practitioners (doctors, other healthcare professionals) | 6 | 35% |
| Scientists | 2 | 12% |
| Science communicators (journalists, bloggers, editors) | 1 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 97 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 10% |
| Student > Postgraduate | 10 | 10% |
| Student > Doctoral Student | 9 | 9% |
| Researcher | 8 | 8% |
| Student > Bachelor | 8 | 8% |
| Other | 22 | 23% |
| Unknown | 30 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 44 | 45% |
| Engineering | 7 | 7% |
| Nursing and Health Professions | 3 | 3% |
| Computer Science | 2 | 2% |
| Agricultural and Biological Sciences | 2 | 2% |
| Other | 2 | 2% |
| Unknown | 37 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 June 2018.
All research outputs
#3,289,211
of 25,756,911 outputs
Outputs from Clinical Orthopaedics & Related Research
#603
of 7,324 outputs
Outputs of similar age
#53,531
of 405,428 outputs
Outputs of similar age from Clinical Orthopaedics & Related Research
#13
of 106 outputs
Altmetric has tracked 25,756,911 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,324 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one has done particularly well, scoring higher than 91% of its peers.
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We're also able to compare this research output to 106 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.