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Any cortical bridging accurately, reliably predicted supracondylar femur fracture healing
Results showed any radiographic cortical bridging by 4 months after treatment of supracondylar femur fractures with locking plate fixation accurately and reliably predicted outcomes of final healing.
William D. Lack, MD, and colleagues assessed postoperative radiographs of 82 supracondylar femur fractures treated with locking plate fixation until final follow-up for cortical bridging at each cortex on anterior-posterior and lateral views.
Compared with criteria requiring bicortical bridging and tricortical bridging, results showed the earliest accurate predictor of final union was assessment for any cortical bridging. Researchers found any cortical bridging could be assessed by 4 months postoperatively. However, according to results, maximal predictive accuracy required assessment at 6 months and 21 months postoperatively for bicortical bridging and tricortical bridging, respectively. Researchers noted any cortical bridging had higher interobserver reliability vs. bicortical or tricortical bridging.
“Radiographic bridging in the first 4 months postoperatively supports observation and aids surgeons in avoiding unnecessary surgical interventions for fractures that are continuing to heal, while lack of radiographic bridging by 4 months should raise suspicion of impending nonunion and may aid surgeons in avoiding delay to necessary surgical treatment of nonunion,” Lack told Healio.com/Orthopedics. “It should be stressed that like all imaging findings, appropriate use of this assessment is dependent upon serial clinical evaluation including assessment of factors, such as pain and functional improvement.” – by Casey Tingle
Disclosures: The researchers report no relevant financial disclosures.