Tornillos de bloqueo corticales lejanos en las fracturas de fémur distal / Far cortical locking screws in distal femur fractures

Este artículo es originalmente publicado en:

Orthopedics. 2015 Mar 1;38(3):e153-6. doi: 10.3928/01477447-20150305-50.

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Copyright 2015, SLACK Incorporated.


Distal femur fractures routinely heal by secondary bone healing, which relies on interfragmentary motion. Periarticular locking plates are commonly used for fixation in distal femur fractures but are associated with a high nonunion rate, likely due to the stiffness of the constructs. Far cortical locking (FCL) screws are designed to allow micromotion at the near cortex while maintaining purchase in only the far cortex. Although clinical data are limited, these screws have been shown in biomechanical studies to provide excellent interfragmentary motion, and animal models have shown increased callus formation compared with traditional locking screws. The purpose of this study was to examine the clinical effects that FCL screws have on healing in distal femur fractures treated with locked constructs. In this retrospective case series, 15 patients with a distal femur fracture treated with MotionLoc screws (Zimmer, Warsaw, Indiana) were analyzed. Serial radiographs were evaluated for callus presence and time to union. All fractures were either 33-A3 or 33-C2 according to the AO classification system, and 5 (33%) were open. Bone loss was recorded in 2 patients. There were no nonunions, and average time to union was 24 weeks. There were no implant failures, and all 5 open fractures, including the 2 with bone loss, healed without intervention. There was 1 reoperation due to painful hardware. Although this is a small case series, these results are promising. Far cortical locking screws may provide the answer to the high nonunion rate associated with distal femur fractures treated with traditional locked constructs. [Orthopedics. 2015; 38(3):e153-e156.].

Las radiografías seriadas fueron evaluadas para determinar la presencia de callos y el tiempo de consolidación. Todas las fracturas eran o bien 33 o 33-A3-C2 según el sistema de clasificación de AO, y 5 (33%) estaban abiertas. La pérdida de hueso se registró en 2 pacientes. No hubo faltas de unión, y el tiempo medio de consolidación fue de 24 semanas. No hubo fracasos de implantes y los 5 fracturas abiertas, incluyendo el 2 con pérdida de masa ósea, curado sin intervención. Hubo 1 reintervención por hardware doloroso. Aunque se trata de una pequeña serie de casos, estos resultados son prometedores. Tornillos de bloqueo corticales distales pueden proporcionar la respuesta a la alta tasa de falta de unión asociado con las fracturas de fémur distal tratados con construcciones cerradas tradicionales
Copyright 2015, SLACK Incorporated.




[PubMed – in process]

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