Modified Use of the Proximal Humeral Internal Locking System (PHILOS) Plate for Distal Femoral Nonunions

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2022 Jan 21

PMID 35061100

Authors

Josje Poelmann

Peter Kloen

Affiliations

Soon will be listed here.

Abstract

Purpose: Nonunion is a common complication after a distal femoral fracture (DFF). Standard treatment consists of revision plating and/or bone grafting. Single lateral plating for a distal femoral nonunion can be insufficient in case of a persistent medial gap and compromised bone stock. Alternatively, dual plating can be used to treat a distal femoral nonunion, but to date there is no Gold standard. The aim of our study was to report our results after use of a minimally invasively placed proximal humeral internal locking system (Philos) plate as a medial buttress in the treatment of a distal femoral nonunion.

Methods: Fifteen adult patients with a distal femoral nonunion were prospectively entered in a trauma database and retrospectively assessed. All patients underwent a similar operation, which included removal of failed hardware, nonunion debridement, fixation with a lateral plate, and a medial Philos plate combined with bone grafting. Data collected included union rate, time to union, complications and functional outcome.

Results: In twelve out of fifteen patients (80%), the fracture united after our index operation. Median time to union was 4.8 months (range 1.6-15). Three patients (20%) needed additional bone grafting surgery. One patient underwent a Judet quadricepsplasty.

Conclusion: This study suggests that the Philos plate is a safe and effective adjunct as a medial buttress plate for distal femoral nonunions.

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