{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:10:24Z","timestamp":1794604224126,"version":"4.9.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>To identify risk factors of reoperation to promote union or to address deep surgical-site infection (DSSI) in periprosthetic distal femur fractures treated with lateral distal femoral locking plates (LDFLPs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Multicenter retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Ten level-I trauma centers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient Selection Criteria:<\/jats:title>\n            <jats:p>Patients with Orthopaedic Trauma Association\/Association of Osteosynthesis (OTA\/AO) 33A or 33C periprosthetic distal femur fractures who underwent surgical fixation between January 2012 and December 2019 exclusively using LDFLPs were eligible for inclusion. Patients with pathologic fractures or with follow-up less than 3 months without an outcome event (unplanned reoperation to promote union or for deep surgical infection) before this time point were excluded. Fracture fixation constructs used medial plates, intramedullary nails, or hybrid fixation constructs were excluded from analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n            <jats:p>To examine the influence of patient demographics, injury characteristics, and features of the fracture fixation construct on the occurrence of unplanned reoperation to promote union or to address a DSSI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>There was an 8.3% rate (19\/228) of unplanned reoperation to promote union. Predictive factors for the need for reoperation to promote union included increasing body mass index (odds ratio [OR] = 1.09; 95% confidence interval [CI]: 1.02\u20131.16; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.01), increasing number of screws in the distal fracture segment (OR = 1.73; 95% CI: 1.06\u20132.95; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03), and decreasing proportion of proximal segment screws that are locking (OR = 0.17; 95% CI: 0.03\u20130.70; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02) There was a 4.8% rate (11\/228) of reoperation to address DSSI. There were no statistically significant predictive factors identified as risk factors of the need for reoperation to address DSSI (<jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>8.3% of periprosthetic distal femur fractures treated at 10 centers with LDFLPs underwent unplanned reoperation to promote union. Increasing patient body mass index and increasing number of screws in the distal fracture segment were found to be predictive factors, whereas increased locking screws in the proximal segment were found to be protective. 4.8% of patients in this cohort underwent reoperation to address DSSI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002779","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T16:01:27Z","timestamp":1706544087000},"page":"273-278","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Risk Factors of Failure in 228 Periprosthetic Distal Femur Fractures: A Multicenter Study"],"prefix":"10.1097","volume":"38","author":[{"given":"Marshall James","family":"Fairres","sequence":"first","affiliation":[{"name":"Harbor-UCLA Medical Center, Torrance, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dane","family":"Brodke","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"O'Hara","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai","family":"Devana","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Hernandez","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Burke","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayesh","family":"Gupta","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"McKibben","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"O'Toole","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Morellato","sequence":"additional","affiliation":[{"name":"University of Mississippi, Jackson, MS;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunter","family":"Gillon","sequence":"additional","affiliation":[{"name":"University of Mississippi, Jackson, MS;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murphy","family":"Walters","sequence":"additional","affiliation":[{"name":"University of Mississippi, Jackson, MS;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colby","family":"Barber","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University, Richmond, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Perdue","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University, Richmond, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Dekeyser","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillia","family":"Steffenson","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Marchand","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren","family":"Black","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University, Portland, OR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Working","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University, Portland, OR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Roddy","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf El","family":"Naga","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hogue","sequence":"additional","affiliation":[{"name":"University of Iowa, Iowa City, IA; 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