Background To analyze the risk factors of revision operation after the treatment of distal femoral fracture with lateral locking plate (LLP). Methods Retrospective analysis of the clinical data of 152 cases with distal femoral fracture treated in our hospital from March 2005 to March 2019. The SPSS 26.0 software (univariate analysis and logistic regression analysis) was used to analyze the general condition, fracture-related factors, operation-related factors, and construct characteristics of internal fixation. Results Sixteen of 152 patients who were included in the study underwent revision surgery, with a revision rate 10.5%. Univariate analysis showed that there were significant differences in age, body mass index (BMI), fracture type, supracondylar involved or not, type of incision, quality of reduction, ratio of length of plate/fracture area (R1), the ratio of the length of the plate/fracture area above the condylar (R2), ratio of distance between proximal part of fracture and screw/working length of proximal plate (R3) between the two groups ( P < 0.05). Logistic regression analysis showed that age [OR for age > 61.5 group is 4.900 (1.071–22.414)], fracture type [OR for A3 fracture is 8.572 (1.606–45.750), the OR for periprosthetic fracture after TKA is 9.073 (1.220–67.506)], poor reduction quality [OR is 7.663 (1.821–32.253)], and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors ( P < 0.05). Conclusion Age, fracture type (A3 and periprosthetic fracture after TKA), poor reduction quality, and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors of the revision in distal femoral fractures treated with lateral locking plate. The appropriate application of the locking plate and operation strategy are the key to reduce the revision rate in distal femoral fractures.

The cement augmentation technique using poly(methyl methacrylate) (PMMA) is considered to be the most effective method for fixation of osteoporotic fracture because of its outstanding mechanical properties. However, the low bio-degradation of PMMA, which hinders bone ingrowth, limits it potential for a broad range of applications. Previous studies have shown blending β-tricalcium phosphate (β-TCP) with PMMA was able to improve the osteoconduction while the material still suffered poor mechanical properties due to the poor compatibility between two components. In this study, we explored the use of hydroxyethyl methacrylate (HEMA) as a compatibilizer for improving the affinity of TCP/PMMA blends system. The resultant TCP/HEMA/PMMA(THP) composite cements exhibited similar setting properties to PMMA cement but much better mechanical properties than composite systems without HEMA as a compatibilizer. No cytotoxicity or hemolysis was observed in the THP bone cement system by biochemical assays. Bone ingrowth was significantly improved at 12 weeks. The reinforced pull-out strength of screws was observed at 4, 8, 12 weeks through in vivo studies performed on rabbit femurs. The THP system, as an injectable bone cement material, shows great potential for use in the cement augmentation technique.