Nov 27, 20 locked plating lp of distal femoral fractures has become very popular. Axsos 3 titanium distal lateral femur locking plate. Oct 15, 2007 distal femur fractures are unstable injuries that are generally treated wit h surgical fixation to maintain alignment of the extremity during the healing process. Proximal femoral replacement total femur replacement distal femoral replacement. Cgma center for gait and movement analysis physical therapy guidelines for orthopedic procedures pt02. Lcp periarticular plating system the lcp periarticular plating system is capable of addressing. Pdf retrograde intramedullary nailing for distal femur. Implant design and material of new generation distal femur. Indications include the proximal humerus, distal femur, and proximal and distal tibia.
Pdf what is new in distal femur periprosthetic fracture. Cartilage repair center tom minas, md, ms 850 boylston street, suite 112 andreas gomoll, md chestnut hill, ma 02467 courtney vanarsdale, pac p. Lcp distal femur plates, sterile only stainless steel titanium holes length 02. We investigated four plate systems for distal femur fixation axsos. Supracondylar femoral fractures hoffa fracture 33b3 coronal split posterior femoral condyle no dcs dynamic condylar screw no blade plate 7. Distal femoral osteotomy physical therapy protocol phase i. Despite technique suggestions from anecdotal and some early reports, knowledge about risk factors for failure, nonunion nu, and revision is limited. From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus is on creating a welldesigned plating system, giving you more. Open reduction and internal fixation of the distal femur animesh agarwal definition distal femur fractures are difficult, complex injuries that can result in devastating outcomes.
Chapter 53 fractures of the distal femur china quad diaries. Axsos 3 titanium monoaxial locking plate system operative technique. Medical device lateral distal femur plate axsos for you 3. The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. To define the anatomic safe zone for placement of external fixator half pins into the anterior and lateral femur. This step also shows the position of a later placed screw and shows its relation to the joint surface. Management of distal femur fractures in adults request pdf. Individuals with a physical disability such as cerebral palsy cp are at risk for fragility fractures osteoporosis secondary to osteopenia from decreased weightbearing. By orthopaedic trauma institute at ucsf featuring amir matityahu.
Visualization of the distal femur under fluoroscopy in both the lateral and ap views is necessary. Besides the t2 femoral nail with a 3m radius of curvature, stryker offers also a 1. Distal femur zone from the articular surface to the metadiaphyseal junction approximately 15 cm from the articular surface. Monoaxial locking plate for treating distal femur fractures. Distal lateral femoral plate proximal lateral tibial plate distal anterolateral tibial plate distal medial tibial plate the axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur, proximal tibia, and the distal tibia. A sterile tourniquet may be useful if treating a distal femur fracture.
Fractures of the thighbone that occur just above the knee joint are called distal femur fractures. Construct stiffness affects healing of bones fixed with locking plates. Implant material and design alter construct stiffness in distal femur. Axsos locking plate system distal lateral femoral plate please note. Implant design and material of newgeneration distal femur. Using fluoroscopy, the position of this kwire can be checked to ensure correct plate positioning. Aug 14, 2010 ipsilateral fractures of the diaphysis and both ends of femur are extremely rare injuries, with the diaphyseal trauma dominating the clinical picture.
The epidemiology of fractures of the distal femur sciencedirect. The system allows for polyaxial screw placement with subsequent screw locking for improved stability especially within osteopenic bone. In addition, modern human condyles are more concave and elliptical in shape to accommodate the elliptical femoral distal condyles. The arcos modular femoral revision system meets the demands of complex hip revision surgery by offering surgeons and or staff the ability to customise both the hip implant and its corresponding instruments in a way that addresses patient and practice needs. Our portfolio of lower extremities products includes a comprehensive array of intramedullary nails, locking plates, external fixation, and biologics. Internal fixation of typec distal femoral fractures in oste. The axsos locking plate system is indicated for fixation of long bone fractures including fractures of the distal radius, the proximal humerus, the distal tibia, proximal tibia and the distal femur. Visualisation of the distal femur under fluoroscopy in both the lateral and ap views is necessary. Two distal or posterior augments may be stacked creating a 10mm femoral augment. Open reduction and internal fixation of the distal femur. In 20 freshfrozen hemipelvis specimens, the femoral nerve and all branches crossing the femur were dissected out to their final muscular locations.
Distal femur fractures are challenging injuries, frequently resulting in complications like nonunions, malunions, knee stiffness and infections. Research editors and board members are on file with the publication and can be viewed on request. The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practical and. Download fulltext pdf what is new in distal femur periprosthetic fracture fixation. The distal femoral osteotomy system utilizes the same principles of design featured in the tibial osteotomy system. Later, osteotomy and plating for deformity correction sh salter harris sh grade is unknown by patient history fig. Prep and drape the leg circumferentially extending proximal to the hip to allow proximal extension of the surgical incision if needed. Visualization of the distal femur under fluoroscopy in. Distal femur fractures and its treatment with distal femur locking plate kanav padha, sandeep singh, abdul ghani, harish dang the incidence of distal femur fractures is around 37 100,000 patients per year.
Elevation of the femur in tha through a direct anterior approach. About about europe pmc funders joining europe pmc governance roadmap outreach. Distal femur plates of the axsos 3 titanium system can be inserted. The slots in the tibial template coincide with the level of the proximal tibial resection for the different allpoly tibial components or the mrh tibial inserts figure 1b. The two most common methods of fixation are intramedullary nailing and plate fixation. The safe zone for external fixator pins in the femur. Specifically designed femoral osteotomy plates take into account the anatomical differences between the distal femur and proximal tibia. Tumors themselves, and the medications used in the management of tumors, can lead to worsened. Implant design and material of newgeneration distal femur locking. Femur fractures common injury due to major violent trauma 1 femur fracture 10,000 people more common in people 65 yo femur fracture leads to reduced activity for 107 days, the average length of hospital stay is 25 days motor vehicle, motorcycle, auto pedestrian, aircraft, and gunshot wound accidents are most.
Retrograde intramedullary nailing has been considered a good surgical. Trifocal femur fractures are those of the femoral neck, diaphysis, and distal femur. Distal femur fractures of the elderly different treatment options in a biomechanical comparison article in injury 427. The distal femoral nail dfn is indicated for the stabilization of fractures of the distal femur. Cuhkolc surgeon education program the 56th orthopaedic trauma workshop the 25th comprehensive bioskill course on fracture fixation 15th 16th december 2012 special theme. Experimental and numerical investigation into the influence of. Although use of a distal femur lateral locking plate with or without application of lag screws has been the gold standard during the last decade, most recent works reported high rates of defective callus formation, delayed union, nonunion, malrotation, and implant failure, especially in comminuted cases, despite use of a single ordinary or mini.
Distal femur growth plate closed sh closed reduction, percutaneous pinning, and casting. Small percutaneous incisions into the origin of the adductor longus, gracilis and occasionally, the adductor brevis. Distal lateral femoral plate the axsos locking plate system is intended for use in long bone fracture fixation. A multicenter randomized trial comparing im nails and plate. The system design is based on clinical input from an international panel of experienced surgeons, data from literature, and both practicaland biomechanical testing. The system design is based on clinical input from an international panel of experienced surgeons, data from.
Internal fixation of distal femur fractures with the less invasive stabilizing system liss, orthopedics and traumatology 9 2001, 166184 indications the less invasive stabilisation system for distal femur lissdf is indicated for the stabilisation of fractures of the distal femur. Periprosthetic distal femur fractures above a tka have a wide range of treatment options, without a single method definitively known to be superior. Ipsilateral fractures of the femoral neck, shaft and distal. Distal condylar screws are parallel to the joint surface to provide a stable support structure in the metaphyseal region multiple points of fixation increased strength optimized fit percutaneous instrumentation stable support inspired by anatomy inspired by simplicity fracturespecific solutions proximal femur. Choose the corresponding size 5mm augment for the femoral component. A maximum of three augments maybe used between the distal surface and posterior condyle. Martinet et al epidemiology of fractures of the distal femur statistics from ao documentation from the 1st jan. This wire should be parallel to the joint line to assure proper alignment of the distal femur. Distal femur thighbone fractures of the knee a fracture is a broken bone. The axsos locking plate system is intended for use in long bone fracture fixation. Axsos1 locked plating comparison of subject to predicate subject device predicate device axsos distal lateral femur axsosthi distal lateral. These highenergy injuries predominantly occur in young people with the potential for longterm complications and disability. Distal femur angular deformity physeal fracture spica cast distal femoral epiphysis these keywords were added by machine and not by the authors.
Mix bone cement and place cement on the internal surface of the. We present the cases of two men who were treated with proximal dynamic hip screws and distal periarticular locking plates to effectively manage trifocal femur fractures. The distal femur is where the bone flares out like an upsidedown funnel. The axsos periarticular locking plate system is strykers range of axially stable locking plates with locking screws designed to treat peri or intraarticular fractures. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. Tibial bone preparation open the tibial medullary cavity with the. Hip adductor contracture and scissor gait pattern procedure. The distal part of the femur is considered the most distal 9 to 15 cm of the femur and can involve the articular surface. Both techniques are considered the standard of care. The purpose of this study was to analyze the complications and clinical outcomes of lp treatment for distal femoral fractures.
Supine with option to flex the knee up to 60 over a leg support. All surgical techniques are available as pdf files. Secure the total femur coupler trial to the diaphyseal. Fixation of distal femoral fractures remains a challenge. Distal femur fractures and its treatment with distal femur. Implant material and design alter construct stiffness in. The medical device lateral distal femur plate axsos for you 3 hole left femur 10 l238mm is realized by stryker trauma ag. Axsos 3 titanium distal lateral femur locking plate system. Proximal and distal tibia, proximal humerus and distal femur.
Highly unstable complex c3type distal femur fracture. Knifelight femur axsos locking plate system carpal tunnel. From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus is on creating a welldesigned plating system, giving you more time to focus on other things. Nov 30, 2017 this feature is not available right now. Dfn distal femoral nail surgical technique standard locking spiral blade locking. Distal femur fractures orthopaedic trauma association ota. Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. The axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur, proximal tibia, and the distal tibia. Pathoanatomy trapezoidal shape medial aspect of trochlear groove is lower incorrect hardware placement will.
Aug 06, 2017 supracondylar femoral fractures muller ao classification of fractures 3 femur 33 distal femur a1 a2 a3 b1 b2 b3 c1 c2 c3 c complete articular a extraarticular b partial articular 6. Implant material and design alter construct stiffness in distal femur locking plate fixation. Other risk factors often coexist including poor nutri. During torsional loading of the constructs with the axsos plate, contact. Please note that axsos 3 titanium is made out of a titanium alloy ti6al4v and is not compatible with any stainless steel plates or screws. Femur axsos 3 titanium operative technique distal lateral femur. In the current retrospective cohort study comparing the outcomes of orif vs dfr for rorabeck type ii fractures, we found similar functional outcomes between cohorts as measured by the kss. Gmrs distal femoral surgical protocol alternatively, the mrhallpoly tibial template can be attached to the distal femoral template. If the fractures around hip are excluded, 31% femoral fractures involve distal portion 1.
The axsos 3 titanium locking plate system is intended for long bone fracture fixation. Fractures of the distal femur whether supracondylar. Distal lateral femur ts plates of the axsostm locking plate system cleared under k061012 in regards to intended use, design, materials, and operational principles as a bone fixation device. The minimum bone resection should be 120mm or 100 mm if the special distal femur 90 mm is used, available on demand. The arcos systems three proximal and five distal geometry options. Pdf implant material and design alter construct stiffness in distal. The comparatively larger lateral proximal condyle also seen on the femur and helps to create the bicondylar angle is an adaptation to increased weight transfer through the femur and into the foot. Tomofix medial distal femur plate surgical technique depuy synthes companies 1 warning. Kickstand screw designed to capture medial malleolus. Medical device lateral distal femur plate axsos for you 3 hole left femur 10 l238mm 627610. Proximal lateral tibia proximal medial tibia distal medial tibia distal anterolateral tibia 4. Immediate postoperative weeks 0 to 6 goals protect healing tissue control pain and edema obtain full knee extension restore knee flexion regain quadriceps control weight bearing toe touch weight bearing for six weeks range of motion. Therefore, it is imperative to purposely look for signs of fractures to the proximal and distal femur on radiographs, especially when injuries are associated with highenergy trauma. Axsos 3 titanium operative technique 6 patient positioning.
Medical device lateral distal femur plate axsos for you. Surgical approach surgeon may use an anterolateral or lateral parapatellar approach. Clinical outcomes of locked plating of distal femoral. The conventional sps small and basic fragment sets are standard plating. Management of extraarticular deformity in the setting of. An external file that holds a picture, illustration, etc. Knee distal femur and proximal tibia efossils resources. If you believe that the public display of this file breaches please. Viewing the distal femur under fluoroscopy in both the lateral and ap view is necessary. We investigated four plate systems for distal femur fixation axsos, lcp, periloc, polyax of differing designs and materials using bone substitutes in a distal femur fracture model otaao 33a3. This process is experimental and the keywords may be updated as the learning algorithm improves. When using the direct anterior approach in tha, view of and access to the acetabulum seem equal to those for any other surgical approaches 10, whereas a more demanding task is preparation of the femur 10.
546 550 811 572 364 125 12 958 598 710 1006 359 92 1276 1415 1388 43 661 1516 1274 1277 1331 706 814 1420 278 215 175 1543 1206 506 590 999 879 538 838 411 1339 1262 70 1432 1285 987 295 1074