Risk factors for failure of distal femoral nonunion repair
Approximately 1 in 6 patients required additional nonunion surgery. In unadjusted analyses, initial high-energy injuries and more prior surgeries were associated with increased odds for additional nonunion surgery, suggesting that the severity of the initial injury is associated with subsequent nonunion treatment outcomes. The current study findings suggest that distal femoral nonunion repair should be based on revision fixation using augmented lateral locking plate (dual-plate or nail-plate) or blade plate constructs. However, these findings are based on unadjusted comparisons. Larger studies with sufficient power to correct or stratify for confounding are needed to further define optimal treatment.
Authors
- Devon T. Brameier (ORCID: https://orcid.org/0000-0002-8221-1172)
- Stein J. Janssen (ORCID: https://orcid.org/0000-0003-3939-7765)
- Noa H. M. Ponds
- Peter Kloen (ORCID: https://orcid.org/0000-0003-1338-4771)
- Robert Kaspar Wagner (ORCID: https://orcid.org/0000-0002-7031-1643)
- Jacob S.W. Borgida (ORCID: https://orcid.org/0009-0005-5443-2591)
- Thuan V. Ly (ORCID: https://orcid.org/0000-0001-6208-5490)
- Michael J. Weaver (ORCID: https://orcid.org/0000-0003-0909-7825)
- Jochem H. Raats (ORCID: https://orcid.org/0009-0002-1531-4857)
- Mitchel B Harris
Institutions
- Massachusetts General Hospital (US)
- Center for Orthopaedics (US)
- Amsterdam University Medical Centers (NL)
Publication Details
- Journal
- European Journal of Orthopaedic Surgery & Traumatology
- Published
- 2025-08-10
- DOI
- https://doi.org/10.1007/s00590-025-04460-9
- Primary Topic
- Bone fractures and treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00