Treatment of Distal Femur Fractures With the DePuy-Synthes Variable Angle Locking Compression Plate. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: McDonald, Tyler C.; Lambert, Joella J.; Hulick, R. Miles; Graves, Matthew L.; Russell, George V.; Spitler, Clay A.; Bergin, Patrick F.
• Is Part Of: Journal of orthopaedic trauma. Volume 33:Issue 9(2019)
• Publication Date: 2019-09
• Subjects: distal femur fracture -- DePuy-Synthes VA-LCP; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000001510
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To determine the failure rate of the DePuy-Synthes variable angle locking compression curved condylar plate (VA-LCP) and quantify failure modes. Design: Retrospective review. Setting: Level I Trauma Center. Patients/Participants: One hundred thirteen patients with 118 OTA/AO classification 33A and 33C distal femoral fractures were included in the study. Intervention: Internal fixation using only the DePuy-Synthes VA-LCP plate. Main Outcome Measurements: Primary outcomes included mechanical failure rate of the DePuy-Synthes VA-LCP plate in open and closed fractures. Secondary outcomes included overall failure rate of treatment, risk factors for mechanical failure, and the specific location of failure: loss of fixation in the proximal segment, implant failure over the working length, or failure of locking screw fixation distally. Results: There were 11 total failures (9.3%) in 118 fractures. Failure rates for the closed and open fracture groups were 5.4% and 15.9%, respectively. Twenty patients (16.9%) required reoperation to promote union. Open fractures ( P = 0.00475), the presence of medial metaphyseal comminution ( P = 0.037), the length of the zone of comminution ( P = 0.037), and plate length ( P = 0.0096) were significantly higher in those with implant failure. Most failures (63.6%) were in the working length of the implant. Conclusions: The use of the Synthes VA-LCP is a viable option in distal femoral fractures and has an acceptable failure rate and reoperation to promote union rate. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Abstract : Supplemental Digital Content is Available in the Text.