Abstract
Introduction: Nonunion rates of distal femur fractures range between 10 and 20%. Previous studies have tried to identify parameters that predict impaired bone healing. These factors include local changes after major trauma such as open fractures and highly comminuted fractures. In addition to these local factors, increasing evidence suggests that the systemic inflammatory response induced by major trauma also impairs bone regeneration. We retrospectively studied patients with distal femur fractures and aimed to identify parameters that predict impaired fracture healing.
Patients and methods: All patients with distal femur fractures treated at a level one trauma center and two large teaching hospitals with locked plating techniques between January 2007 and December 2014 were included. Using multivariable logistic regression, we determined which parameters were independent predictors of impaired fracture healing.
Results: A total of 58 fractures in 56 patients were analysed. 26 fractures were caused by high-energy trauma (45%) and 26 patients developed impaired healing (45%). Impaired fracture healing occurred more frequently after High Energy Trauma (p<0.001), open fractures (p<0.001), comminuted fractures (p=0.001) and in younger patients (p<0.001). High Energy Trauma remained an independent predictor of impaired fracture healing when open fractures and comminution were included in the multivariable logistic regression.
Conclusion: High energy trauma, open fractures and comminution were all identified as independent predictors of impaired fracture healing. This indicates that high energy trauma, regardless of the fracture type that results, may negatively affect fracture healing.
Citation
Karhof S, Bastian OW, van Olden GDJ, Leenen LPH, Kolkman KA and Blokhuis TJ. Impaired Fracture Healing of the Distal Femur after High Energy Trauma. SM J Arthritis Res. 2017; 1(1): 1003.