Evidence map›Paper›PMID 39876949›Full record

ArticleJournal of hand and microsurgery2025

Treatment of distal femur aseptic nonunion after lateral locking plate fixation: Results of medial custom made plating and free fibula flap transfer using CAD-CAM technology.

Vittorio Ramella, Gianluca Canton, Micol Dussi, Cristina Formentin, Veronica Scamacca, Filippo Bagnacani, Trobec Belinda, Luca Spazzapan, Luigi Troisi, Laura Grezar and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hand and microsurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Vittorio RamellaPlastic, Reconstructive and Aesthetic Surgery Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Gianluca CantonOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Micol DussiOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Cristina FormentinOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Veronica ScamaccaOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Filippo BagnacaniOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Trobec BelindaOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Luca SpazzapanPlastic, Reconstructive and Aesthetic Surgery Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Luigi TroisiHead of the Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation - San Giuseppe Hospital - IRCCS MultiMedica Group, Milan, Italy.
Laura GrezarPlastic, Reconstructive and Aesthetic Surgery Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Giovanni PapaPlastic, Reconstructive and Aesthetic Surgery Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Luigi MurenaOrthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Aim of the present paper is to report the preliminary results of CAD-CAM (Computer-Aided Design - Computer-Aided Manufacturing) technology application to distal femur nonunion treatment with free fibula flap, custom made medial plating and maintenance of a stable lateral locking plate. Methods: Two cases of distal femur nonunion that occurred after lateral locking plating were treated and prospectively followed-up. Surgical planning followed the same preoperative protocol adopted for mandibular CAD-CAM reconstruction. Wide cutting sections were planned to obtain radical debridement. The tailored custom-made plate, a 3D rendering of bone defect and the cutting guides were produced and sterilized. Surgical intervention was conducted by steps (medial approach, bone resection, recipient vessels isolation, fibula harvesting and cutting, plate-fibula construct assembly, microvascular anastomosis, final fixation). Results: The mean follow-up was 13 (12-15) months. Bone union was achieved in both cases at mean 3.1 months. Full weight bearing without referred pain or discomfort was reached in both cases at mean 8,5 months (range 7-10). No complications occurred. Conclusions: CAD-CAM technology proved to be useful and reliable in custom made medial plating combined with free fibula transfer for the treatment of distal femur nonunion after lateral locking plating. Trial registration: none.

Indexed as

CAD-CAMCustom madeDistal femurFree fibula flapNonunion

Identifiers

PMID39876949
PMCPMC11770210

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.