DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20194552

A prospective study for the treatment of femur bone fracture following femur plate fixation with a screws to achieve initial stability and early mobilization

Pooja Rawat, Mohit Kumar, Gaurav Luthra

Abstract


Background: Fractures of the femur are relatively common, most often is caused by high-energy trauma in young and low-energy trauma in older persons. Femur fractures were classified according to Arbeitsgemeinschaft für Osteosynthesefragen system which included proximal, diaphyseal and distal.

Methods: 30 patients prospective data was collected with a year of follow up. Clinical and radiological follow-ups were conducted at four weeks, twenty-four week, and forty-eight week after the discharge to check the bone union and implant-related complications. Three different plates were used for the treatment of fracture as per the fracture type (4.5/5.0 mm wise-lock distal femur plate, 4.5/5.0 mm wise-lock proximal femoral plate, 4.5/5.0 mm wise-lock proximal lateral femur plate (type II), 4.5/5.0mm wise-lock osteotomy medial distal femur plate). The patient's health status was evaluated by American Society of Anesthesiologists grade and the visual analog score (VSA) was also obtained.

Results: The gradual decrease of the VSA score showed the results of the good significance related to pain management. The continued Physiotherapy under the supervisor of physiotherapists in all patients after discharge helps in good recovery and earlier mobilization. In the series of our 30 patients, no biomechanical complication was observed related to implant plate and screw-like loosening, bend, corrosion, etc.

Conclusions: Femoral system (Auxein Medical Private Limited, India) is effective as a treatment for femur bone union. Definitive treatment of femur bone fracture fixation with Femoral System have good rate of success of mobilization and bone union in this study.


Keywords


Femur fracture, Medial end, Diaphyseal fracture, Partial articular fracture, Simple fracture, Proximal femur plate, Distal fracture, Locking plate, Nonunion, Outcomes

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References


Standring S. Gray’s Anatomy of the Human Body. Pelvic girdle, gluteal region and hip joint. 39th edition. Section 8. chapter111. Churchill Livingstone Publication; 2005.

Smith JAR, Mc Lauchlan J. A survey of fractures of proximal end of femur. Injury. 1975;6(3):196-201.

Uhthoff H, Poitras P, Backman D. Internal plate fixation of fractures: short history and recent developments. J Orthop Sci. 2006;11:118-26.

Ebraheim N, Buchanan G, Liu X, Cooper M, Peters N, Hessey J, et al. Treatment of Distal Femur Nonunion Following Initial Fixation with a Lateral Locking Plate. Orthop Surg. 2016;8:323–30.

Gunadham U, Jampa J, Suntornsup S, Leewiriyaphun B. The Outcome in Early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur Locking Compression Plate. Malaysia Orthop J. 2014;8:2.

Canadian Orthopaedic Trauma Society. Are Locking Constructs in Distal Femoral Fractures Always Best? A Prospective Multicenter Randomized Controlled Trial Comparing the Less Invasive Stabilization System With the Minimally Invasive Dynamic Condylar Screw System. J Orthop Trauma. 2016;30:e1–e6.

Hodel S, Beeres F, Babst R, Christian B. Complications following proximal femoral locking compression plating in unstable proximal femur fractures: medium-term follow-up. European J Orthop Surg Traumatol. 2017;12:1117-24.

Yamauchi K, Fushimi K, Shirai G, Fukuta M. Comparison of Functional Recovery in the Very Early Period after Surgery between Plate and Nail Fixation for Correction of Stable Femoral Intertrochanteric Fractures: A Controlled Clinical Trial of 18 Patients, Geriatric. Orthop Surg Rehab. 2014;5(2):63-8.

Kumar G, Sharma G, Farooque K, Sharma V, Ratan R, Yadav S, et al. Locking Compression Plate in Distal Femoral Intra-Articular Fractures: Our Experience. International Scholarly Research Notices. 2014;2014:372916-21.

Shin Y, Han S. Periprosthetic fracture around a stable femoral stem treated with locking plate osteosynthesis: distal femoral locking plate alone versus with cerclage cable. Eur J Orthop Surg Traumatol. 2017;27(5):623-30.

Weng C, Wu C, Feng K, Tseng I, Lee P, Huang Y. Comparison of supraintercondylar and supracondylar femur fractures treated with condylar buttress plates. BMC Musculoskeletal Disorders. 2016;17:413.

Perisano C, Barone C, Stomeo D, Giacomo G, Vasso M, Panni A, et al. Indications for prophylactic osteosynthesis associated with curettage in benign and low-grade malignant primitive bone tumors of the distal femur in adult patients: a case series. J Orthopaed Traumatol. 2016;17:377–82.

Dhamangaonkar A, Joshi D, Goregaonkar A, Tawari A. Proximal femoral locking plate versus dynamic hip screw for unstable intertrochanteric femoral fractures. J Orthop Surg. 2013;21(3):317-22.

Imerci A, Canbek U, Karatosun V, Karapınar L, Yes M. Nailing or plating for subtrochanteric femoral fractures: a non-randomized comparative study. European J Orthop Surg Traumatol. 2015:25(5):889-94.

Mathias H, Huber H, Dierauer S, Ramseier L. Fixation of subtrochanteric extending/derotational femoral osteotomies with the Locking Compression Plate in ambulatory neuro-orthopaedic patients. J Children’s Orthopaed. 2010;4(5):423-8.

Henderson CE, Lujan T, Bottlang M, Fitzpatrick DC, Madey SM, Marsh JL. Stabilization of distal femur fractures with intramedullary nails and locking plates: differences in callus formation. Iowa Orthop J. 2010;30:61-8.

https://www.aofoundation.org/Documents/mueller_ao_class.pdf. Accessed on 31st August 2018.