DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20195814

Assessment of functional outcome of distal femur intra-articular fractures treated with locking compression plate

Neetin Pralhad Mahajan, Ved Ashish Ravesh, Prasanna Kumar G. S., Ajay Chandanwale, Lalkar Gadod

Abstract


Background: Intra-articular distal femoral fracture makes up to 6% of all femur fractures. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. The locking compression plates have nowadays proven to be gold standard in treating both simple as well as complex intra-articular distal femur fractures. This study is to evaluate the complications, functional and anatomical outcome of distal femur fractures, treated by open reduction and internal fixation using distal femoral locking compression plate.

Methods: This is a retrospective study of 30 patients with intra articular distal femur fractures operated with distal femur locking compression plate during the period of 2015 to 2018 in a tertiary care hospital with age range from 17 to 71 years and follow up till 2 years. Fractures were classified according to AO classification and functional outcome assessed by using Neer criteria.

Results: 10 cases had excellent score (33%), 16 cases (52%) had satisfactory score, 3 cases (11%) had unsatisfactory score and only one case had poor score. 85.1% of patients were in between satisfactory to excellent results. Complications observed were excessive bleeding, difficulty in reduction, superficial infections, knee stiffness, malalignment and limb length discrepancy.

Conclusions: The distal femur locking compression plate is a good implant to be used for distal femur intra-articular fractures. Early surgery, anatomical reduction and early mobilisation are the prerequisites for good functional outcome. Comminution and bone defect on the medial side needs pillar reconstruction by fibular bone graft.


Keywords


Distal femur fractures, Locking plate, Funcional outcome, Complications

Full Text:

PDF

References


Martinet O, Cordey J, Harder Y, Maier A, Buhler M, Barraud GE. The epidemiology of fractures of the distal femur. Injury. 2000;31(3):C62-3.

Donald AW. Supracondylar and intracondylar fractures of the femur. In: Fractures in Adults. The Rockwood CA Jr, Green D (adults), 4th edition. Philadepphia, JB: Lippincot; 1996: 1973-95.

Schandelmaier P, Partenheimer A, Koenemann B. Distal femoral fractures and LISS stabilization. Injury. 2001;32(3):55-63.

Ehlinger M, Ducrot M, Adam P, Bonnomet F. Distal Femur Fracture. Surgical Techniques and a Review of the Literature. Orthop Traumatol Surg Res. 2013;99:353-60.

Ricci WM, Tornetta P, Petteys T, Gerlach D, Cartner J, Walker Z, et al. A comparison of screw insertion torque and pullout strength. J Orthop Trauma. 2010;24(6):374-8.

Perren, SM. Evolution of the internal fixation of long bone fractures. J Bone Joint Surg [Br]. 2002;84:1093-110.

Borgeaud M, Cordey J, Leyvraz PF, Perren SM. Mechanical analysis of the bone to plate interface of the LC-DCP and of the PC-FIX on human femora. Injury. 200;31:SC29-36.

Turner IG, Rice GN. Comparison of bone screwholding strength in healthy bovine and osteoporotichuman cancellous bone. Clinical Materials. 1992;9:105-7.

Schütz M, Müller M, Regazzoni P, Höntzsch D, Krettek C, Van der Werken C, et al. Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Arch Orthop Trauma Surg. 2005;125(2):102–8.

Bucholz RW, Heckman JD. Rockwood and Green’s Fracture in Adults, 8th Edition. Lippincott Williams and Wilkins, a Walters Kluwer business, USA: 2015.

Canale and Beaty. Campbell's Operative Orthopaedics, 12th ed. Mosby, Elsevier; 2012.

Ru J, Hu Y, Liu F. Treatment of distal femur fracture by less invasive stabilisation system-distal femur 2007;21(12):1290-4.

Link B.C, Babst R. Current Concepts in Fractures of the Distal Femur. Acta Chirurgiae Orthopaedicae. 2012;79:11-20.

Trivedi NP, Chauhan RH, Padhiyar DR, Gandhi SP. Outcome of Fracture of Inta articular Distal Femur treated with Distal Femur Locking Compression Plate. Int J Res Orthop. 2015;1(1):22-7.

Daroch MS, Vashisht D, Sreen S. Management of intra-articular fracture of distal femur with LCP and Lag screws in adults. Int J Res Med Sci. 2017;5:1434-8.

Kiran Kumar GN, Sharma G, Farooque K, Sharma V. Locking compression plate in distal femoral intra articular fractures: our experience. International scholarly research. 2014: 372916.

Kanabar P, Kumar V, Jowen P, Rushton N. Less invasive stabilisation system plating for distal femoral fracture- J Orthopedic Surg. 2007;15(3):299-302.

Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Intraarticular fractures of distal femur-A long term follow up study of surgically treated patients. J Orthop Trauma. 2004;18(4):213-9.