Of 103 patients who had a fracture of the distal third of the femur that
was treated by open reduction and internal fixation with a condylar
blade-plate, sixty-two had removal of the plate after the fracture had
united. The mean interval between injury and removal of the plate was
twenty-six months. Six patients (10 per cent) sustained a refracture that
was unrelated to major trauma; the refracture occurred twelve to
ninety-three days after removal of the plate. Five of the six refractures
occurred through a hole of a supplemental interfragmentary lag-screw. The
use of such screws significantly increased the risk of refracture after
removal of the hardware (p less than 0.01). The refractures were treated by
intramedullary nailing in five patients and by replating in one, and union
was achieved in all six patients. Routine removal of a condylar blade-plate
after union of a fracture of the distal third of the femur cannot be
recommended, especially in the presence of supplemental fixation with
interfragmentary screws.