{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:36:24Z","timestamp":1792773384039,"version":"4.5.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To investigate clinical, radiographic, and patient reported outcomes in patients undergoing surgical fixation for distal femur fractures with single device construct (lateral locked plate or intramedullary nail) or nail-plate combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single, academic, tertiary Level I trauma center<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>The inclusion criteria were patients with DFFs (OTA\/AO 33) treated operatively with lateral locked plate, IM nail, or nail-plate combination between January 2011 and December 2023 with a minimum follow up of 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n                    <jats:p>Radiographic fracture healing, complication rates, weight-bearing status, length of stay, gait impairment, and patient-reported outcomes using the Patient-Reported Outcomes Measurement Information System were investigated. Multivariable regression models were used to identify predictors of union, reoperation, discharge disposition, and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 191 patients were included, with 153 (131 lateral locked plate, 22 intramedullary nail) treated with a single device construct (mean age 72 years [range 22\u201395], 16% male) and 38 treated with nail-plate combination constructs (mean age 70 years [range 19\u201394], 16% male). At one-year postoperatively, nail-plate combination versus single device constructs were associated with significantly lower rates of nonunion (0% vs. 12%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03), reoperation (10% vs. 26%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.05), and gait impairment (26% vs. 58%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). Patients in the nail-plate combination group versus the single device group were more likely to be weight bearing as tolerated at discharge (63% vs. 3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) and more frequently discharged home (42% vs. 15%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Fixation with nail-plate combination constructs, compared with single device constructs, in DFFs seemed to support immediate weight bearing and was associated with improved short-term and midterm outcomes, including reduced rates of nonunion, reoperation, and functional impairment at 1 year. These advantages may be especially relevant for geriatric patients and those with complex or periprosthetic fracture patterns, or with preoperative risk factors for nonunion and functional decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003232","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:00:39Z","timestamp":1779883239000},"page":"583-589","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Nail-Plate Constructs Permit Early Weight Bearing and Improved Outcomes Compared With Single Device Constructs in the Treatment of Distal Femur Fractures at One-Year Follow-Up: A Retrospective Analysis"],"prefix":"10.1097","volume":"40","author":[{"given":"Urvi J.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, MaineHealth, Portland, ME"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa R.","family":"Holloway","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery & 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