{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T19:34:13Z","timestamp":1776800053781,"version":"3.51.2"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T00:00:00Z","timestamp":1697932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Distal femoral fractures are a significant injury sustained by low\u2010 and high\u2010energy trauma. Common treatment practices are lateral locking plate or intramedullary nail fixation, with disadvantages including risk of non and malunion and limited post\u2010operative weightbearing status. Combining both techniques as a nail\u2010plate construct (NPC) theoretically achieves enhanced fixation to allow immediate weightbearing. The aim of this study is to examine radiographic union, malunion and patient\u2010reported outcomes in distal femur NPC fixation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center retrospective study including all patients &gt;18\u2009years who sustained distal femur fractures treated with NPC. Primary outcomes were radiographic union, malunion and patient reported outcome measures at minimum 1\u2010year follow\u2010up. Secondary outcome measures included post\u2010operative mobility, length of stay and complications. Relevant variables of normality are reported as mean with standard deviation. Subgroup analysis of patients aged &lt;65 and \u226565\u2009years are provided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen patients were included in the study. Rate of radiographic union was 100%. There was no case of malunion. All patients were allowed to bear full weight immediately post\u2010operatively. Mean length of stay was 9.50\u2009days, with 37.5% of patients discharged directly home. The majority (85.7%) of patients returned to pre\u2010injury mobility. Early post\u2010operative complications occurred in three patients. Three patients returned to theater. The mean EQ\u20105D\u20105L index value was 0.713, with 71.4% describing no problems with self\u2010care and 85.7% reporting no or slight problems with usual daily activities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The NPC provided stable fixation permitting full weightbearing post\u2010operatively with no cases of non or malunion. Return to pre\u2010injury mobility and activity are encouraging. Based on these results we support the use of nail\u2010plate construct fixation in the management of distal femur fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13927","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:14:20Z","timestamp":1698020060000},"page":"3326-3334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail\u2010Plate Construct"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8806-4388","authenticated-orcid":false,"given":"Benjamin","family":"Pfister","sequence":"first","affiliation":[{"name":"Orthopaedic Surgery Department Lismore Base Hospital  Lismore NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Wilson","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Department Lismore Base Hospital  Lismore NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herwig","family":"Drobetz","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Department Lismore Base Hospital  Lismore NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874325001711011277"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.10.014"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001332"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1683444"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.05.024"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.344.14752"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000002"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/873785"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002588"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-019-02453-z"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B11.BJJ-2019-0370.R2"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.02.016"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.11.011"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-021-00489-0"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605231187945"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000939"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000390"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198309000-00041"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026810"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2022.11.035"},{"key":"e_1_2_13_23_1","article-title":"Locked lateral plating vs. retrograde nailing for distal femur fractures: a prospective multicenter randomized trial","volume":"37","author":"Dunbar RP","year":"2023","journal-title":"J Orthop Trauma"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000926"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000141935.86481.ba"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-04119-0"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13927","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T08:22:12Z","timestamp":1702974132000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13927"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,22]]},"references-count":25,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/os.13927"],"URL":"https:\/\/doi.org\/10.1111\/os.13927","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,22]]},"assertion":[{"value":"2023-05-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}