Minimally-invasive fixation of distal extra-articular femur fractures with locking plates: Limitations and failures

作者：Ehlinger M^*; Adam P; Arlettaz Y; Moor B K; DiMarco A; Brinkert D; Bonnomet F

来源：Orthopaedics & Traumatology-Surgery & Research, 2011, 97(6): 668-674.

DOI：10.1016/j.otsr.2011.05.004

• Lower extremity fracture
• Femur
• Locking plate
• Failure
• Minimally-invasive surgery
• ORIF

Minimally-invasive fixation using a locking plate and early motion is normal practice. However, technical errors and pitfalls are common. This surgery has a set of rules that encompass both the mechanics of the internal fixation system and the implantation itself. If these rules are not strictly followed, alignment defects and/or early failure of the fixation can occur. We analysed four cases of clinical failure that were encountered after minimally-invasive distal femoral extra-articular fixation with locking plates. The following rules must be followed with this technique: extra-articular fracture, minimally-invasive approach, long plate alternating between locking screw and empty hole (five holes on either side of fracture), bi-cortical screws, placement of locking screws near a complex fracture but away from a simple fracture. Osteoporotic bone, obesity that interferes with the instrumentation, articular fracture, horizontal fracture line and surgeon experience are all limitations of this minimally-invasive technique.

• 出版日期2011-10