Earlier callus formation found with titanium plates for metaphyseal distal femur fractures

Kutzler MA, et al. Paper #14. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 7-11, 2023; Las Vegas.

Kutzler MA, et al. Paper #14. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 7-11, 2023; Las Vegas.

LAS VEGAS — Patients with metaphyseal distal femur fractures had earlier callus formation and bone healing 12 weeks after receiving lateral bridge plates composed of titanium vs. stainless steel, according to presented data.

"We saw increased [modified radiographic union scale] mRUST scores at 12 weeks with titanium vs. stainless steel plates. We saw no significant difference in mRUST scores between 6 and 24 weeks and we saw no difference in union rates," Michael Andrew Kutzler, MD, MS , said at the American Academy of Orthopaedic Surgeons Annual Meeting.

In the retrospective, consecutive cohort study, Kutzler and colleagues evaluated metaphyseal distal femur fracture patterns in adult patients who were treated with a lateral bridge plate. Patients with dual implants or those who did not have radiographic follow-up to union were excluded. The single fellowship-trained orthopedic trauma surgeon in the study had switched to exclusively titanium to exclusively stainless steel about midway through the series, Kutzler said.

In the study, 10 patients received stainless steel lateral bridge plates and 15 patients received titanium lateral bridge plates for an OTA/AO 33-A or 33-C distal femur fracture. Another independent fellowship-trained orthopedic trauma surgeon reviewed AP and lateral postoperative radiographs at 6, 12 and 24 weeks to evaluate mRUST scores.

At 12 weeks, Kutzler and colleagues found increased mRUST scores, which indicated more callus formation, for patients who had received titanium bridge plates. They also found no statistically significant difference in mRUST scores at 6 or 24 weeks. Researchers found seven unions in the stainless steel group and 13 unions in titanium group, as well as two nonunions for patients who had received stainless steel plates compared with one nonunion for a patient in the titanium group.