Risk Factors for Nonunion of Distal Femur Fractures.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors report no conflict of interest. 14. Eur J Orthop Surg Traumatol. 2025 Jun 27;35(1):284. doi: 10.1007/s00590-025-04392-4. Clinical and patient-reported outcomes of distal femur fracture fixation in adults aged 18-50 years. Tung WS(#)(1)(2), Wagner RK(#)(3)(4)(5), Borgida JS(1)(2), Brinkman N(6), Muhammad M(1)(2), Musick AN(1)(2), Gregg AT(1)(2), Policicchio TJ(1)(2), Stenquist DS(1)(2), Ly TV(1)(2). Author information: (1)Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, United States. (2)Harvard Medical School Orthopaedic Trauma Initiative, Boston, United States. (3)Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, United States. r.k.wagner@amsterdamumc.nl. (4)Harvard Medical School Orthopaedic Trauma Initiative, Boston, United States. r.k.wagner@amsterdamumc.nl. (5)Department of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands. r.k.wagner@amsterdamumc.nl. (6)The University of Texas at Austin, Austin, United States. (#)Contributed equally PURPOSE: To describe nonunion and fracture-related infection (FRI) rates and patient-reported outcomes following operative treatment for distal femur fractures in young patients. METHODS: We retrospectively identified all patients (aged 18-50) who were operatively treated for a distal femur fracture between 2006 and 2023 with ≥ 3-month clinical follow-up at two Level 1 Trauma Centers. Outcomes included reoperation for nonunion and FRI; and PROMIS physical function (PF), depression, and anxiety (reference population mean: 50). Multiple linear regression was performed to identify factors associated with PROMIS-PF. RESULTS: Eighty-six patients met inclusion criteria. The median age was 34 years, 71% were male, 42% had an open fracture, and for 38 patients PROMIS scores were collected at an average of 9.8 years after treatment. Eleven patients (13%) required reoperation for nonunion and 3 (3.5%) for FRI. Median PROMIS-PF was 47.0 (IQR: 41.2-52.4), depression 45.8 (IQR: 38.9-53.6), and anxiety 46.7 (IQR: 39.5-60.5). PROMIS-PF was lower than the reference population score (p