Management of distal femur fractures with locking compression plate
Abstract
Background: Distal femur fractures are often caused by high energy trauma mainly sustained in road traffic accidents. Open injuries with considerable comminution of condyles and metaphysis are frequently seen. The present study is undertaken to assess outcome of 20 patients of distal femur fractures treated with locking compression plate.
Methods: 20 cases of distal femur fractures in adults treated by locking compression plate were studied. Of the 20 ‘lower end of Femur’ fractures, 4 were Mullers type A3; 2 were Mullers type B1; 6 were Mullers type C1; 4 were Mullers type C2 and remaining 4 were Mullers type C3. All fractures were closed. Maximum age was 68 years and minimum age was 26 years. 16 were male and 4 were female. Results assessed by time for union, range of motion of knee, shortning, varus/valgus deformity and complications.fuctional assessment was done by Neers scoring.
Result: Most common type of distal femur fracture was Mullers type C1. Of 20 patients, 17 patients (85%) showed radiological union within 18 weeks. Average flexion in this study was 105 degree with more than 65% patients having knee range of motion more than 110 degree. Average extensor lag in this study was 5.60 degrees. 3 had shortening, 2 patients had shortening of 15 mm and 1 had shortening of 10mm.varus / valgus malalignment of less than 5 degree seen in 5 cases.4 patient developed superficial infection.only one patient went into delayed union. 80 % excellent and good results were obtained by Neers scoring.
Conclusion: Locking compression plate is an optimal tool for supracondylar fractures of femur. It provides rigid fixation in region of femur, where a widening canal, thin cortices and frequently poor bone stock make fixation difficult. Surgical exposure for plate placement requires significantly less periosteal stripping and soft tissue exposure than that of normal plates.
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References
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