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Title: Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study
Authors: Karam, James ;Campbell, Paul ;Hunter, Michael ;David, Michael 
Affliation: Central Coast Local Health District
Gosford Hospital
The University of Newcastle
Issue Date: May-2019
Source: 14(1):150
Journal title: Journal of Orthopaedic Surgery and Research
Department: General Surgery
Abstract: BACKGROUND: The primary aim was to compare the outcomes of locked plating of closed distal femur periprosthetic and non-periprosthetic fractures by testing the hypothesis that outcomes would be worse in the periprosthetic group. The secondary aim of this study was to identify risk factors for non-union. METHODS: A single-center study over an 8-year period utilizing a retrospective cohort design was performed. Sixty-eight patients with periprosthetic fractures and 57 patients with non-periprosthetic fractures met inclusion criteria for the study. There was a significant difference between groups in mean age (80.1 years periprosthetic vs. 70.9 years non-periprosthetic (p < 0.001)). Statistical analysis between groups was used to assess the outcomes of time to union, incidence of non-union, post-operative functionality, incidence of complications, progression to revision surgery, and mortality. A secondary multivariable analysis was used to assess risk factors for non-union and factors positively associated with union. RESULTS: There were no significant differences in outcomes between groups. Union rates were 83.8% (57/68) in the periprosthetic group and 78.9% (45/57) in the non-periprosthetic group (p = 0.648). Comminution was identified as a significant risk factor for non-union (p = 0.005). Use of a submuscular technique had a significant positive association with union (p = 0.006). CONCLUSIONS: Outcomes of surgical treatment for periprosthetic and non-periprosthetic distal femur fractures are similar. There is a significant risk of non-union in locked plating of both groups.
DOI: 10.1186/s13018-019-1204-z
ISSN: 1749-799x
Publicaton type: Journal Article
Keywords: Surgery
Study or Trial: Cohort Study
Appears in Collections:Health Service Research

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