Introduction
Materials and methods
Results
Femoral shaft fractures in polytraumatised patients
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n = 1 delayed union (0.7%)
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n = 1 superficial wound infection (0.7%)
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n = 36 pulmonary complications (25.5%) (n = 26 IM group, n = 10 double-plating group)
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n = 5 multiple organ failure (3.6%)
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n = 7 mortality during hospitalisation (5.0%).
Title | Authors | Journal | Year | Level of evidence | Number of cases | Treatment | Mean follow-up (months) | Fracture healing | Complications | Functional outcome at final follow-up |
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Double-plating fixation of comminuted femoral shaft fractures with concomitant thoracic trauma | Cheng et al. | Journal of International Medical Research | 2018 | IV | n = 15 Mean age: 38.7 years Range of age: 21–58 years | LCP anterior surface of femoral shaft LCP or distal femoral locking titanium plate lateral | 14.2 (SD 12–24) | Union was achieved in 14 of 15 patients Mean time of healing: 9.2 months | n = 2 1 delayed union 1 superficial wound infection | Range of motion of knee flexion 116.4 (+-6,9) Mean Nonarthritic Hip Score and Lysholm Knee Score was 89 (+-7.8) points and 87 (+ -8.4 points) |
Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries: a retrospective comparative study | Cheng et al. | Journal of Investigative Surgery | 2019 | IV | n = 126 84 patients treated with intramedullary nailing Mean age: 36.2 Range of age: 19–67 42 patients treated with locked dual plating Mean age: 38.6 years Range of age: 21–69 years | Interlocking intramedullary nailing Locked dual plating (LCP) | Intramedullary nailing 16.4 Locked dual plating 18.9 | Bony union was achieved in 98.4% after 32.5 weeks and 36.3 weeks in the intramedullary nailing and locked dual plating groups | n = 48 IMN group: 26 pulmonary complications 3 multiple organ failures 5 deaths caused by ARDS, pulmonary contusion, multiple organ failure, brain trauma LDP group: 10 pulmonary complications 2 multiple organ failures 2 deaths caused by multiple organ failure | Harris Hip Score (points) Interlocking intramedullary nailing: 86.1 ± 10.2 Locked dual plating: 88.3 ± 9.4 Lysholm Knee Score (points) Interlocking intramedullary nailing: 85.1 ± 16.2 Locked dual plating: 83.3 ± 14.4 |
Methodology criterion (max score) | Mean score (SD) |
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Part A | |
1. Study size | 5 (5) |
2. Mean follow-up (months) | 2 (0) |
3. N procedures | 10 (0) |
4. Type of study | 0 |
5. Diagnostic certainty | 5 (0) |
6. Description of surgical procedure given | 5 (0) |
7. Description of surgical procedure given | 10 (0) |
Part B | |
1. Outcome criteria | 2 (0) |
2. Outcome assessment | 4 (0) |
3. Outcome assessment | 5 (0) |
Coleman methodology score (CMS) | 48 (5) |
Distal femoral fracture
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n = 9 infection (8.3%)
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n = 10 non-union (9.3%)
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n = 2 mortality during hospitalisation (1.9%)
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n = 3 mild pain at the iliac grafting donor site (2.8%)
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n = 2 arthrolysis under general anaesthesia at 3 weeks after surgery because of a clear delay in rehabilitation response and fear of development of arthrofibrosis (1.9%)
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n = 2 delayed tibial tuberosity osteotomy healing for more than 12 weeks (1.9%)
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n = 2 delayed wound healing (1.9%)
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n = 1 deep-vein thrombosis (0.9%)
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n = 6 screw breakage or cut-out in one of the plate fixations with no loss of reduction (5.6%).
Title | Authors | Journal | Year | Level of evidence | Number of cases | Treatment | Mean follow-up (months) | Fracture healing | Complications | Functional outcome at final follow-up |
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Double-plating of comminuted, unstable fractures of the distal part of the femur | Sanders et al. | The Journal of Bone and Joint Surgery | 1991 | IV | n = 9 Mean age: 39 years Range of age: 21–75 years | Lag screw and condylar buttress plate lateral, in the distal part cancellous bone screws, medial plate and bone graft | 26 (SD 2–34) | All 9 fractures healed in an average time of 6.7 months (SD 5–9 months) | n = 0 | 5 good and 4 fair functional results were achieved according to methods of Sanders et al. Flexion of the knee: 3 patients had < 90°, 5 patients 90°-100°, 1 patient > 100°. 1 patient was always pain free and none patient had pain at rest |
Lateral and anterior plating of intra-articular distal femoral fractures treated via an anterior approach | Ziran et al. | Internantional Orthopedics | 2002 | IV | n = 36 displaced distal femoral fractures Mean age: n.a Range of age: n.a | Anterior approach and double-plating lateral plate (condylar or blade) and anterior plate (reconstruction or 3.5 mm dynamic compression) | 7 (SD 3–44) two patients died during hospitalization, one patient was lost to follow-up | Uneventful healing by 16 weeks occurred in 24 of 36 cases 3 non-unions | n = 8 2 died during hospitalization (non-related cause to surgery), 3 non-unions 1 superficial wound infection 2 infection (1 of which resulted in amputation below the knee) | Mean arc of motion was from 5° (5°–35°) − 100° (20°–130°) flexion |
Highly unstable complex C3-type distal femur fracture: can double plating via a modified Olerud extensile approach be a standby solution? | Khalil Ael-S et al. | Journal of Orthopedics and Traumatology | 2012 | IV | n = 12 Mean age: 33.5 years Range of age: 22–44 years | Ipsilateral iliac bone was draped for autografting Lateral locked distal femur plate Contoured medial plate (reconstruction plate in eight cases, semitubular plate in four cases) Lateral distal femur locked plate and a medial contoured plate through a modified Olerud extensile approach | 13.7 (SD 11–18) | All cases had radiological healing. Mean healing time 18.3 months (SD 12–28 weeks) with 4 cases having a delayed union (more than 24 weeks) | n = 15 4 delayed unions (more than 24 weeks) 3 cases (25%) had mild pain at the iliac grafting donor site 2 cases (16.7%) had manipulation under general anaesthesia after 3 weeks from surgery due to manifest delay in rehabilitation response 2 superficial infections (16.7%), 2 delayed wound healings (16.7%) 2 delayed tibial tuberosity osteotomy healings for more than 12 weeks (16.7%) | 7 of 12 cases had excellent and good results (58.4%); 3 cases had fair results (25%); 2 cases had poor results (16.7%) according to methods of Sanders et al |
Double plating of intra-articular multifragmentary C3-type distal femoral fractures through the anterior approach | Imam et al. | European Journal of Orthopaedic Surgery & Traumatology | 2017 | IV | n = 16 supracondylar Femoral fracture type C3 Mean age: 36 years Range of age: 18–59 years | Countersunk cancellous screws size 4 or 6.5 mm followed by applying a distal femoral locked plate sub-musculary on the lateral surface of the condyle; application of contoured medial plate (proximal tibia in ten cases, distal tibia in six cases); bone grafting from the iliac bone | 11.5 (SD 6–24) | Complete radiological union was 6.0 ± 3.5 months (SD 3–14 months) with one case having a delayed union | n = 4 1 nonunion (6.25%); 2 infections (12.5%); 1 needed revision (6.25%) | Eleven had well-to-excellent functional outcome (68.75%) Poor outcome in two patients (12.5%) according to methods of Sanders et al |
Comparison of Clinical Efficacy of Lateral and Lateral and Medial Double-plating Fixation of Distal Femoral Fractures | Bai et al. | Scientific Reports | 2018 | IV | n = 60 distal femoral fractures n = 48 treated with lateral plate (single plate) n = 12 treated with lateral plate and medial plate (double plating) Mean age: n.a Range of age: n.a | Single-plate group Double plate group: after setting the lateral plate, if varus stress was positive and lateral collateral ligament rupture excluded, medial double plating was used | Single plate group: 15.2 Double plate group: 18.5 | Single-plate group: union was achieved in 47 cases (97,9%) Mean time of healing: 14.3 Double plate group: union was achieved in all 12 cases 100% Mean time of healing: 18 months | Single-plate group: n = 1 1 non-union (2,1%), retreated with autologous iliac bone graft and lateral anatomical plate fixation, which then healed Double-plate group: n = 0 | Single-plate group: excellent and good results in 39 of 48 cases (81.3%); fair results in 7 cases (14.6%) and poor results in 2 cases (4.2%) according to Kolmert´s standard Double-plate group: excellent and good results in 9 of 12 cases (75%); fair results in 2 cases (16.7%); poor results in 1 case (8.3%) according to Kolmert´s standard |
Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures | Metwaly et al. | Geriatric Orthopaedic Surgery and Rehabilitation (GOS) | 2018 | III | n = 23 distal osteoporotic femoral Fractures (AO 33-A3, 33-C1-3) Mean age: 69.6 years Range of age: 61–80 years | Medial: antishear plate (locked L-plate or medial distal femoral osteotomy locked plate) Lateral: long-locked lateral distal femoral plate minimally invasive percutaneous plate osteosynthesis (MIPPO) | 14.1 SD (12–36) | Union was achieved in 19 cases (82.6%) 4 (17.4%) cases needed autologous bone graft after 6 months Mean time of union: 9 months (SD 3–12 months) | n = 9 (39.1%) 2 superficial infections 1 deep-vein thrombosis 6 screw breakage or cut-out in one of the plate fixations no loss of reduction | The mean EQ-5D-5 L score was 83.8 (72–92) 100 means the best health the patient can get and 0 means the worst health knee range of motion was 3°-5° less when compared to the contralateral nonfractured side |
Methodology criterion (max score) | Mean score (SD) |
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Part A | |
1. Study size | 2.5 (2.7) |
2. Mean follow-up (months) | 1.8 (1.7) |
3. N procedures | 9.5 (1.1) |
4. Type of study | 1.7 (3.7) |
5. Diagnostic certainty | 5 (0) |
6. Description of surgical procedure given | 10 (0) |
7. Description of surgical procedure given | |
Part B | |
1. Outcome criteria | 2 (0) |
2. Outcome assessment | 4 (0) |
3. Outcome assessment | 5 (0) |
Coleman methodology score (CMS) | 41.5 |
Periprosthetic femoral fracture
Title | Authors | Journal | Year | Level of evidence | Number of cases | Treatment | Mean follow-up (months) | Fracture healing | Complications | Functional outcome at final follow-up |
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Clinical and radiological results of patients treated with orthogonal double plating for periprosthetic femoral fractures | Müller et al. | International Orthopaedics | 2014 | IV | n = 10 n = 5 fractures around a total hip prosthesis n = 1 fracture around a total knee prosthesis n = 1 interprosthetic fracture n = 3 implant failure after the stabilisation of periprosthetic fractures around a total hip prosthesis n = 1 or total knee prosthesis n = 2 mean age: 79.5 years range 55–91 years | Double plating lateral plating: 13–20 holes: LISS, LCP, NCB Anterior plating: 8–14 holes: LCP | 22.6 SD [6–42] 2 patients lost due to dead not related to surgery | 7 of 8 fractures healed within follow-up | n = 1 1 implant failure | 7 patients presented with radiologically confirmed bony consolidation with the repaired extremity bearing their full weight All patients were subjectively satisfied with their clinical outcome Therefore, 7 out 10 patients showed excellent results according to Beals and Tower |
A double-plating approach to distal femur fracture: A clinical study | Steinberg et al. | Injury | 2017 | IV | n = 32 n = 8 periprosthetic fractures n = 24 femoral fractures including 2 non-unions and 1 open fracture mean age: 76 years range of age: 44–101 years | Lateral locking plate and medial plate | 12 SD [8–20] | 30 of 32 fractures healed within 12 weeks (range 6–21 weeks) | n = 5 1 delayed union 1 a shaft fracture 2 superficial wound infections 1 deep infection after union | All fractures, excluding 1 that needed bone grafting and 1 refracture, healed radiographically within a mean of 12 weeks (range 6–21 weeks) and clinically within 11 weeks (range 6–17 weeks) Axial alignment was good in all cases, but 1 fracture had a valgus of 8°. Range of motion were for extension 0°-20° and for flexion 85°–120° |
An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate fixation | Çiçek et al. | Acta Orthopaedica et Traumatologica Turcica | 2018 | IV | n = 22 distal femur periprosthetic fractures following total knee arthroplasty Su Type 3 mean age: 73 years range of age: 68–82 years | Medial and lateral locking plate (LCP) n = 18 spongious autograft | 69 SD[53–85] | 20 of 22 fractures healed within 18.5 weeks (range 14.2–22.8 weeks) | n = 3 1 non-union 1 loss of reduction 1 superficial infection | Union was observed in 20 patients KSS was 81.8 ± 7.8 (range 56–90) WOMAC score was 78.1 ± 5.3 (range 62–88) ROM was 98.1° ± 8.2° (range 70°–110°) Mean time to pain-free weight bearing was 4.9 ± 1.1 (range 4–8) months |
Dual plate fixation results in improved union rates in comminuted distal femur fractures compared to single plate fixation | Bologna et al. | Journal of Orthopaedics | 2019 | IV | n = 21 distal femoral fractures n = 13 treated with lateral distal femoral locking plate (single plate) n = 8 treated with precontoured distal femoral locking plate lateral and straight locking plate anteromedial (double plating) Mean age: 61 years Range of age: n.a | Standard lateral approach Lateral distal femoral locking compression plate (single plate) Extensile parapatellar approach (double plating) Precontoured distal femoral locking plate was placed along the lateral distal femur, a straight locking plate was placed to the anteromedial surface of the distal femur | 12 [6–29] | Single plate: 4 of 13 healed Dual plate: 8 of 8 healed | Single plate: n = 10 6 non-unions 3 delayed unions 1 infection Dual plate: n = 4 2 significant knee stiffness 2 mild anterolateral heterotopic ossifications | Single plate: knee range of motion 100° (92.5–115º) Dual plate: knee range of motion 90° (70.0–90.0°) |
Excellent outcomes after double-locked plating in very low periprosthetic distal femoral fractures | Park et al. | Archives of Orthopaedic and Trauma Surgery | 2020 | IV | n = 21 distal femur periprosthetic fractures following total knee arthroplasty Su Type 3 Mean age: 76 years range of age: 56–90 years | Lateral: LCP Medial: LCP and Philos to the distal femur | 12 | 20 of 21 fractures healed within 14 weeks (range 10–21 weeks) | n = 8 1 non-union 3 superficial infection 4 soft tissue healing | Of the 21 fractures, 20 (95%) healed primarily within 14 weeks (range 10–21 weeks). All cases achieved satisfactory limb alignment, with an m-LDFA of 89.6º (range 85–92°) and m-PDFA of 86.5º (range 70–130°) on average Average ROM: 114° (range 70–130°) The mean Knee Society knee and function scores were 94 (range 83–100) and 89.5 (range 76–99), respectively |
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n = 1 non-union (1.0%)
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n = 2 implant failure (2.1%)
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n = 3 delayed union (3.1%)
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n = 6 superficial wound infection (6.3%)
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n = 1 reduction loss (1.0%)
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n = 1 deep infection (1.0%)
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n = 4 complication in soft tissue healing (4.2%)
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n = 2 significant knee stiffness (2.1%)
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n = 2 mild anterolateral heterotopic ossification (2.1%)
Methodology criterion (max score) | Mean score (SD) |
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Part A | |
1. Study size | 3.2 (1.6) |
2. Mean follow-up (months) | 2.6 (1.2) |
3. N procedures | 9.4 (1.2) |
4. Type of study | 0 (0) |
5. Diagnostic certainty | 5 (0) |
6. Description of surgical procedure given | 5 (0) |
7. Description of surgical procedure given | 10 (0) |
Part B | |
1. Outcome criteria | 2 (0) |
2. Outcome assessment | 4 (0) |
3. Outcome assessment | 5 (0) |
Coleman methodology score (CMS) | 46.2 |
Pathological fractures of the proximal femur
Title | Authors | Journal | Year | Level of evidence | Number of cases | Treatment | Mean follow-up (months) | Outcome | Functional outcome |
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Double-plate compound osteosynthesis for pathological fractures of the proximal femur: high survivorship and low complication rate | Merckaert et al. | Archives of Orthopaedic and Trauma Surgery | 2019 | IV | n = 61 Mean age: 63.5 Range of age: 39.6–92.7 | n = 46 double-plate compound osteosynthesis n = 15a double-plate compound osteosynthesis was performed as revision procedure | 22 (2.4–306) | Construct survival rates of 96% at 6 months, and 90% thereafter for primary reconstructions Comparing the calculated survivorship with the literature, it is evident that double-plate compound osteosynthesis is superior to simple open reduction and internal fixation with or without cement augmentation, intramedullary nailing and comparable if not higher than endoprosthetic replacement | The mean Merle d’Aubigné score was 14 ± 7 (range 3–17), at 0–3 months, 13 ± 3 (7–18), at 3–6 months, 15 ± 3 (9–18), at 6–12 months and 15 ± 4 (8–18) thereafter |
Compound osteosynthesis for osteolyses and pathological fractures of the proximal femur | Kinkel et al. | 2009 | IV | n = 34 n.a n.a | n = 34 n = 22 double-plate compound osteosyntheses n = 12 single-plate compound osteosyntheses | n.a | Survival time after compound osteosynthesis was 14.2 months (range 0–72 months) Double-plate compound osteosyntheses showed a lower mechanical failure rate than single-plate compound osteosyntheses (14.3% vs 33.3%) and a higher survival probability after 5 years (76.4% vs 38.6%) No surgical revision was required due to perioperative complications in any case | n.a |
Methodology criterion (max score) | Mean score (SD) |
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Part A | |
1. Study size | 7 (3) |
2. Mean follow-up (months) | 1 (1) |
3. N procedures | 10 (0) |
4. Type of study | 0 |
5. Diagnostic certainty | 5 (0) |
6. Description of surgical procedure given | 5 (0) |
7. Description of surgical procedure given | 10 (0) |
Part B | |
1. Outcome criteria | 2 (0) |
2. Outcome assessment | 4 (0) |
3. Outcome assessment | 5 (0) |
Coleman methodology score (CMS) | 49 |
Non-union of the femur
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n = 4 infection (2.1%)
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n = 1 sacral sore (0.5%)
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n = 2 postoperative seroma (1.0%)
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n = 4 blood transfusion (2.1%)
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n = 1 HDU admission (0.5%)
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n = 1 periprosthetic fracture (0.5%)
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n = 2 fatigue failure (1.0%)
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n = 1 malunion (0.5%)
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n = 1 persistent non-union (0.5%)
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n = 1 loss of motion of one knee (0.5%)
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n = 12 movement limitation (6.2%)
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n = 9 muscle atrophy (4.7%)
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n = 2 failure of attachment of the greater trochanter (1.0%)
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n = 7 symptomatic hardware (3.6%)
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n = 1 breakdown of the posterior iliac crest harvest site (0.5%)
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n = 1 deep-vein thrombosis (0.5%)
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n = 1 pulmonary embolism (0.5%).
Title | Authors | Journal | Year | Level of vidence | Number of cases | Treatment | Mean follow-up (months) | Fracture healing | Complications | Functional outcome at final follow-up |
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Treatment of Supracondylar Nonunions of the Femur with Plate Fixation and Bone Graft | Chapman et al. | The Journal of Bone and Joint Surgery | 1999 | IV | n = 18 Mean age: 47 years Range of age: 25–81 years | 13 double plates, 4 single plates, and 1 interfragmentary screw Autologous bone graft used in all cases Condylar buttress plate antero-medial 95-degree screw and side-plate lateral | 26 [SD 6–120] 1 patient lost to follow-up | All 18 non-unions had healed Average time to healing: 8 months (SD 3–20 months) | n = 3 1 infection 1 loss of motion of the knee 1 malunion | Range of motion of the knee was 101°(10°–135°) |
Reattachment of complex femoral greater trochanteric nonunions with dual locking plates | Laflamme et al. | The Journal of Arthroplasty | 2012 | IV | n = 15 Mean age: 68 years Range of age: 42–88 years | 2 locking plates contoured on the anterolateral and posterolateral surface of the greater trochanter Anterolateral plate: locking screws in the proximal and distal fragment | 53.1 [SD 26–88] | Trochanteric union was achieved in 13 out of 15 cases | n = 5 1 associated stem fatigue failure had revision hip arthroplasty 1 failed reattachment 3 hardware removal | Trochanteric union was achieved in 13 patients (87%) Average total hip score was 14.8 ± 2.2 (Merle d'Aubigné) and 77.6 (± 12.8) (Harris Hip score) |
Treatment of the femoral shaft nonunion with double plate fixation and bone grafting: A case series of 14 patients | Maimaitiyiming et al. | Injury | 2015 | IV | n = 14 Mean age: 26 years Range of age 22–32 years | Double-plate fixation combined with bone grafting LCP was placed in the lateral proximal part of the femur LCP which would make a 90° angle to the first plate was placed in the anterior site of the femur | 14.8 [SD 10–25] | Union was achieved in all the patients in a mean of 5.5 months | n = 0 | Excellent results in all cases according to the Paley and Catagni criteria |
Addition of a Medial Locking Plate to an In Situ Lateral Locking Plate Results in Healing of Distal Femoral Nonunions | Holzman et al. | Clinical Orthopedics and Related Research | 2016 | IV | n = 23 Mean age: 58 years Range of age: 35–83 years | 16 aseptic non-unions: single-stage procedure, stable lateral plate and medial LCP with autogenous bone graft 7 non-unions with lateral plate failure: 1. new lateral plate and at least 2 months later a medial LCP with autogenous bone graft | 18 [SD 6–94] 2 patients lost to follow-up | Union was achieved in 20 out of 21 cases within 12 months | n = 6 1 persistent nonunion and lateral broken plate 4 removal of symptomatic hardware 1 breakdown of the posterior iliac crest harvest site | Union was achieved in 20 out of 21 cases within 12 months |
Double locking plate fixation for femoral shaft nonunion | Peng et al | European Journal of Orthopaedic Surgery & Traumatology | 2016 | IV | n = 33 Mean age: 46.9 years Range of age: 25–81 years | Double-locking plate fixation and autogenous cancellous bone graft | 24.8 (SD 6–60) | All 21 femoral non-unions healed Union time was 5.3 months (range 4–7) | n = 0 | 100% union rate, physical function and bodily pain components of the SF-36 were 96 (range 90–99) and 94.2 (range 92–99) |
Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients | Sun et al. | Clinical Research Report | 2019 | IV | n = 21 femoral non-unions Mean age: 42 years Range of age: 23–68 years | Double plating was performed using a locking compression plate and a reconstructive plate, cancellous bone granules were loaded into any bony defects | 14.5 (8–28) | All femoral non-unions healed Average union times 8.2 (range 4–14) | n = 13 9 muscle atrophy 4 joint ankyloses | 100% union rate, all patients achieved an excellent or good result for bone healing and function |
Double-plate fixation together with bridging bone grafting in nonunion of femoral supracondylar, subtrochanteric, and shaft fractures is an effective technique | Mardani-Kivi et al. | MUSCULOSKELETAL SURGERY | 2019 | IV | n = 41 Mean age: 35 years Range of age: 18–71 years | Double-plate fixation and autogenous bridging bone grafting | 37 (SD 18–63) | Full union was obtained in all patients Union time was 5 months (range 4–8) | n = 9 1 deep-vein thrombosis 1 pulmonary embolism 7 movement limitations | 100% union rate, at the final follow-up, 3 patients had 10°–20° movement 1 patient had 10° movement limitations in hip flexion and extension 3 patients had 20°–30° and 10° movement limitations in knee flexion and extension, respectively |
J-bone graft with double locking plate: a symphony of mechanics and biology for atrophic distal femoral non-union with bone defect | Lu et al. | Journal of Orthopaedic Surgery and Research | 2020 | IV | n = 18 Mean age: 47.7 years Range of age: 28–63 years | Atrophic distal femur non-union with bone defect were treated with a combination of J-shaped iliac crest bone graft combined with double plate | 22.1 (SD 14–34) | All 18 patients achieved primary bone healing Healing time was 6.7 months (range 3–12) | n = 3 2 superficial infections 1 knee stiffness | 100% union rate, the mean time to weight bearing walking was 5.5 months (range 3–12) The rate of “excellent” and “good” Lysholm Knee Scoring Scale scores improved from 0% before surgery to 94.44% at 3 months after surgery |
Outcome of revision surgery for bisphosphonate related subtrochanteric fracture non-union following failed intramedullary nailing | Pydisetty et al. | Injury | 2020 | IV | n = 10 Mean age: 71.5 years Range of age: 57–89 years | Lateral dynamic compression screw (DCS) plate and an anterior locking compression plate (LCP) | n.a 1 patient lost to follow-up | All 10 subtrochanteric non-unions healed Union time was 16 months (range 7–32) | n = 11 1 superficial infection 1 sacral sore 2 postoperative seroma 4 blood transfusion 1 HDU admission 1 periprosthetic fracture 1 fatigue failure | 100% union rate, the mean period until fully weight bearing for all patients was 8 months (range 4–17 months |
Methodology criterion (max score) | Mean score (SD) |
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Part A | |
1. Study size | 2.1 (2.5) |
2. Mean follow-up (months) | 3.3 (2.1) |
3. N procedures | 7.8 (4.2) |
4. Type of study | 0 |
5. Diagnostic certainty | 5 (0) |
6. Description of surgical procedure given | 5 (0) |
7. Description of surgical procedure given | 10 (0) |
Part B | |
1. Outcome criteria | 2 (0) |
2. Outcome assessment | 4 (0) |
3. Outcome assessment | 5 (0) |
Coleman methodology score (CMS) | 44.2 |