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Comparing Intramedullary Nailing Versus Locked Plating in the Treatment of Native Distal Femur Fractures: Is One Superior to the Other?

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 23 August 2021

Abstract

Introduction

Distal femur fractures make up < 1% of all fractures and 3–6% of all femur fractures. In the literature, both intramedullary nailing (IMN) and locked plating (LP) have shown favorable results, but there is no consensus on a gold standard. The purpose of this systematic review is to compare outcomes of native distal femur fractures treated via IMN versus LP in an effort to determine if one is superior to the other.

Methods

Systematic review of MEDLINE, EMBASE, and Cochrane Library databases was conducted according to PRISMA guidelines. Only articles published within the last ten years were included. Evidence and study quality were evaluated with the MQOE and Oxford Criteria.

Results

Forty-six articles were included in the review. Fractures treated with IMN were found to have a 93.9% union rate, an average time to union of 19.2 weeks, an average arc of motion of 105.1 degrees, with an average of 14.4 degrees of malalignment. Fractures treated with LP were found to have a 90.2% union rate, an average time to union of 20.5 weeks, an average arc of motion of 104 degrees, with an average of 12.6 degrees of malalignment.

Conclusion

Compiled data comparisons revealed no differences in union rate, malalignment, time to union, average arc of motion, or complication rates requiring a return to the operating room. Until higher level randomized data is available, either IMN or LP are acceptable methods of treatment for native distal femur fractures.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Jersey City Medical Center-RWJBarnabas Health, 377 Jersey Ave, Suite 280A, Jersey City, NJ, 07302, USA

    Jaclyn M. Jankowski, Patrick F. Szukics, Jay K. Shah, David M. Keller, Frank A. Liporace & Richard S. Yoon

  2. Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Felicio Rocho Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Robinson E. Pires

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  1. Jaclyn M. Jankowski
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  2. Patrick F. Szukics
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  3. Jay K. Shah
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Contributions

JJ- study design, literature search, data analysis, manuscript draft. PFS- literature search, manuscript draft. JKS- study design, literature search, data analysis, manuscript draft. DMK- manuscript draft. REP- study design, execution, data interpretation/analysis, manuscript fixation FL- study design, execution, data interpretation/analysis, manuscript fixation. RY- study design, execution, data interpretation/analysis, manuscript fixation. All authors read and approved the final manuscript.

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Correspondence to Richard S. Yoon.

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Jankowski, J.M., Szukics, P.F., Shah, J.K. et al. Comparing Intramedullary Nailing Versus Locked Plating in the Treatment of Native Distal Femur Fractures: Is One Superior to the Other?. JOIO 55, 646–654 (2021). https://doi.org/10.1007/s43465-020-00331-z

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