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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2020, Number 5

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Acta Ortop Mex 2020; 34 (5)

External fixation with reconstruction rail system as a treatment for pseudoarthrosis of the distal femur

Morales-Avalos R, Rodríguez-Torres RA, Martínez-Manautou LE, Rivera-Zarazúa S, Requena-Araujo P, Blázquez-Saldaña J, Peña-Martínez VM
Full text How to cite this article 10.35366/97994

DOI

DOI: 10.35366/97994
URL: https://dx.doi.org/10.35366/97994

Language: Spanish
References: 8
Page: 309-312
PDF size: 303.38 Kb.


Key words:

Pseudoarthrosis, femur, external fixator, no union, treatment.

ABSTRACT

Distal femur pseudoarthrosis also called «distal femur non-union» (DFNU) represents a rare complication associated with a fracture caused by high-energy trauma; its treatment is controversial, as there is a wide variety of surgical techniques that can be implemented, from open reduction plus internal fixation with plates, to the use of fixed angle plates combined with bone autograft. We expose the case of a 24-year-old man who shows up for consultation with the history of having presented a left femoral supracondylar fracture with a year of evolution, treated by osteosynthesis of the distal femur with dynamic condylar screws (DCS plate); developed a torpid evolution with severe pain in the distal third of the left thigh and functional limitation, developed a progressive varus deformity of the left thigh that caused a shortening of 3.8 cm of the limb. A focus of pseudoarthrosis was identified, which was surgically removed, the intramedullary canal was recanalized, and a lateral closed wedge osteotomy was performed to correct the angulation and allow reduction. 5.5 mm (three proximal and three distal) hydroxyapatite screws and an external fixator were placed. In addition, a review of the literature focused on the use of external fixation was carried out as a treatment for the pseudoarthrosis of the distal femur.


REFERENCES

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  2. Griffin XL, Parsons N, Zbaeda MM, McArthur J. Interventions for treating fractures of the distal femur in adults. Cochrane Database Syst Rev. 2015; (8): CD010606.

  3. Ebraheim NA, Martin A, Sochacki KR, Liu J. Nonunion of distal femoral fractures: a systematic review. Orthop Surg. 2013; 5(1): 46-50.

  4. Rodriguez EK, Boulton C, Weaver MJ, Herder LM, Morgan JH, Chacko A, et al. Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures. Injury. 2014; 45(3): 554-9.

  5. Ali F, Saleh M. Treatment of distal femoral nonunions by external fixation with simultaneous length and alignment correction. Injury. 2002; 33(2): 127-34.

  6. Lynch JR, Taitsman LA, Barei DP, Nork SE. Femoral nonunion: risk factors and treatment options. J Am Acad Orthop Surg. 2008; 16(2): 88-97.

  7. Holzman MA, Hanus BD, Munz JW, O’Connor DP, Brinker MR. Addition of a medial locking plate to an in situ lateral locking plate results in healing of distal femoral nonunions. Clin Orthop Relat Res. 2016; 474(6): 1498-505.

  8. Gardner MJ, Toro-Arbelaez JB, Harrison M, Hierholzer C, Lorich DG, Helfet DL. Open reduction and internal fixation of distal femoral nonunions: long-term functional outcomes following a treatment protocol. J Trauma. 2008; 64(2): 434-8.




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Acta Ortop Mex. 2020 Sep-Oct;34