Weight-bearing as tolerated following distal femur fracture surgically treated with Far Cortical Locking screws

Abstract

Objectives To review outcomes of a consecutive, non-selected series of distal femur fractures treated with a dynamic plate construct and allowed unrestricted weight bearing immediately after surgery. Design Retrospective consecutive case series. Setting Level 2 trauma center Patients/Participants Thirty-one consecutive distal femur fractures in 29 patients with 33A and 33C fractures stabilized with a distal femur locking plate and Far Cortical Locking diaphyseal screws. Intervention All patients were allowed immediate unrestricted weight bearing with assistive devices post-surgery. Main Outcome Measure Loss of reduction from immediate post-operative alignment, implant failure, nonunion, and medical complications. Results No loss of alignment greater than three degrees in the lateral distal femoral angle was noted at healing. Two implant failures occurred, one in the first five weeks and another in an established nonunion. Mortality at one year was 6.5%. Readmission for medical complications was noted in 6.5% of patients. Conclusions Immediate, unrestricted weight bearing after fixation of 33A and 33C distal femur fractures with a dynamic plate construct may be safe, with a low risk of implant failure or loss of coronal plane alignment. Relative to historical reports, morbidity and mortality in our cohort were improved with early weight-bearing. Level of Evidence Therapeutic Level IV, case series