SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Nail-plate combination versus single construct for the management of distal femoral fractures: a meta-analysis.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Increased screw backout with non-inlay design retrograde femoral nails.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Nail-Plate Combination Fixation for Periprosthetic Distal Femoral Fractures Allows Early Weight-Bearing With Low Reoperation and Revision Rates.The Journal of arthroplasty · 2026Article
- Smoking, medial comminution, and single fixation as predictors of failure in the fixation of native distal femur fractures: a multicenter retrospective study over 109 fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of distal femoral fractures (DFFs) can be challenging, with a historically high rate of non-union and reoperations. While lateral locked plating and intramedullary nailing were shown to have similar rates of non-union, nail-plate combinations (NPC) have been shown to have higher rates of union and improved clinical outcomes compared to single constructs (SC). The purpose of this meta-analysis was to compare NPC and SC in the treatment of DFFs.
methodsPubMed, Cochrane, and Google Scholar databases (pages 1-20) were queried through October 2024. Studies that compared NPC to SC in patients with DFF were included. Outcomes including overall complications, specific complications (implant failure, heterotopic ossification (HO), nonunion, malunion, and surgical site infection (SSI)), reoperations, immediate post-operative weight-bearing status, and surgery-related parameters (operative room (OR) time, estimated blood loss (EBL), and length of stay (LOS)) were compared between the two groups.
resultsFive retrospective studies including 637 patients met the inclusion criteria (146 patients in the NPC group and 491 patients in the SC group). The NPC group had a lower rate of overall complications (OR 0.21, p < 0.001), reoperations (OR 0.29, p < 0.001), implant failure (OR 0.15, p = 0.01), non-unions (OR 0.12, p < 0.001), and malunion (OR 0.29, p = 0.03). Furthermore, the NPC group had a lower rate of patients instructed to be non-weightbearing post-operatively (OR 0.06; p < 0.001). There was no difference in HO, SSI, OR time, EBL or LOS between the 2 groups.
conclusionThe present meta-analysis demonstrates a reduced rate of complications, reoperations, implant failure, nonunions and malunions in patients undergoing NPC for DFFs. LEVEL OF EVIDENCE: III.
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