Plates, nails may be used alone or together to treat distal femur fractures
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WAILEA, Hawaii — A presenter at Orthopedics Today Hawaii noted plates and nails can be used alone or in conjunction with one another in the treatment of distal femur fractures.
The use of a plate in the treatment of distal femur fractures would be important when performing an articular reduction or direct visualization and open reduction, according to Anna N. Miller, MD.
“You can work around total hip or total knee components potentially a little bit easier with a plate, but there also can be more soft tissue stripping and may be not biologically friendly, although you can place these minimally invasively to be more friendly,” Miller said in her presentation.
When a nail is used, Miller noted patients may have the ability to do early weight-bearing. Although use of a nail is minimally invasive, she said it can be more difficult to maintain alignment with the nail. Miller added surgeons may not be able to use a long nail if the patient already had a total hip replacement.
“Also, there may be some restrictions on what nails you can use based on what total knee they have in place,” Miller said. “If they have a cruciate retaining knee, you may be able to put in a nail, but you have to know what size the opening is before you try to put in a nail that’s bigger than the total knee will allow.”
Miller said surgeons could also consider treating distal femur fractures with both a plate and a nail.
“This is a technique that allows for early weight-bearing and more stability than either a nail or a plate on its own,” Miller said.
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Miller AN. Distal femur peri-prosthetic: When to nail, when to plate and should we ever do both? Presented at: Orthopedics Today Hawaii 2021; May 30-June 3, 2021; Wailea, Hawaii.
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