DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164000

Functional outcome of fixation of distal femoral fractures with DF-LCP: a prospective study

Shafeed T. P., Bijo Paul

Abstract


Background: Management of supracondylar fractures is a real challenge to the orthopaedician due to its extensive soft tissue injury, boneloss, comminution, articular extention and instability. Open reduction and internal fixation with anatomical distal femoral locking plate permits early mobilization. Stable anatomical fixation is necessary to avoid complications and disability.

Methods: 25 patients with Type A and Type C closed supracondylar femoral fractures were followed up from November 2013 to November 2015. All the patients underwent ORIF with DF-LCP. Clinical and radiological follow up were recorded for 24 months.

Results: Mean time for fracture union was 4.02 months. Average duration for full weight bearing was 122 days (range 90-180days). The average range of movement for Type A fractures was 105.71 degrees, for C fractures average ROM was 93.64 degrees. Average ROM for patients <50 was 103 degree and for patients>50 ROM was 98.66 degree.

Conclusions: Locked plating of DF fractures permits stable fixation and early mobilization which avoids disability and ensures good joint function.


Keywords


Distal femoral fracture, DF-LCP, Functional outcome, Neer’s score

Full Text:

PDF

References


Arneson TJ, Melton LJ, Lewallen DG, O'Fallon WM. Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. Clin Orthop Relat Res. 1988;234:188-94.

Watson-Jones R. Fractures and joint injuries. 6th edition. Newdelhi: Churchill Livingstone; 1990.

Sanders R, Swiontowski M, Rosen H, Helfet D. Double plating of comminuted, unstable fractures of the distal femur. J Bone Joint Surg. 1991;73:341-6.

Schatzker J. Fractures of the distal femur revisited. Clin Orthop Relat Res. 1998;347:43-56.

Stephen HL. Supracondylar fractures treated percutaneously. Clin Orthop Relat Res. 2000;375:51-9.

Frigg R. Development of the locking compression plate. Injury. 2003;34(2):6-10.

Wagner M. General principles for the clinical use of the locking compression plate. Injury. 2003;34(2):31-42.

Kregor PJ, Stannard JA, Zlowodzki M, Cole PA. Treatment of Distal Femur Fractures Using the Less Invasive Stabilization System: Surgical Experience and Early Clinical Results in 103 Fractures. J Orthop Trauma. 2004;18(8):509-20.

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

Frigg R, Appenzeller A, Christensen R, Frenk A, Gilbert S, Schavan R. The development of the distal femur Less Invasive Stabilization System (LISS). Injury. 2001;32:24-31.

Weight M, Collinge C. Early Results of the Less Invasive Stabilization System for Mechanically Unstable Fractures of the Distal Femur (AO/OTA Types A2, A3, C2, and C3). J Orthop Trauma. 2004;18(8):503-8.

Fankhauser F, Gruber G, Schippinger G. Minimal-Invasive Treatment of Distal Femoral Fractures with the LISS (Less Invasive Stabilization System): A Prospective Study of 30 Fractures with a Follow Up of 20 Months. Acta Orthop Scand. 2004;75(1):56-60.

Markmiller M, Konrad G, Sudkamp N. Femur-LISS and Distal Femoral Nail for Fixation of Distal Femoral Fractures. Clin Orthop. 2004;426:252-7.

Schutz M, Muller 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.

Wong MK, Leung F, Chow SP. Treatment of Distal Femoral Fractures in the Elderly Using a Less-Invasive Plating Technique. Int Orthop. 2005;29:117-20.

Krettek C, Schandelmaier P, Miclau T, Tscherne H. Minimally invasive percutaneous plate osteo-synthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury. 1997;28(1):20–30.

Rozbruch SR, Muller U, Gautier E, Ganz R. The evolution of femoral shaft plating technique. Clin Orthop. 1998;354:195–208.

Wenda K, Runkel M, Degreif J, Rudig L. Minimally invasive plate fixation in femoral shaft fractures. Injury. 1997;28(1):13–9.

Kinast C, Bolhofner BR, Mast JW, Ganz R. Subtrochanteric fractures of the femur: results of treatment with the 95 degrees condylar blade-plate. Clin Orthop. 1989;238:122–30.

Claes L, Heitemeyer U, Krischak G, Braun H, Hierholzer G. Fixation technique influences osteogenesis of comminuted fractures. Clin Orthop. 1999;365:221–9.

Ostrum RF, Geel C. Indirect reduction and internal fixation of supracondylar femur fractures without bone graft. J Orthop Trauma. 1995;9:278–84.

Leunig M, Hertel R, Siebenrock KA, Ballmer FT, Mast JW, Ganz R. The evolution of indirect reduction techniques for the treatment of fractures. Clin Orthop. 2000;375:7–14.

Wiss DA. What’s new in orthopaedic trauma. J Bone Joint Surg Am. 2001;83:1762–72.

Marti A, Fankhauser C, Frenk A, Cordey J, Gasser B. Biomechanical evaluation of the less invasive stabilization system for the internal fixation of distal femur fractures. J Orthop Trauma. 2001;15:482–7.

Yeap EJ, Deepak As. Distal femoral locking compression plate fixation in distal femoral fractures: Early Results. Malaysian Orthopaedic Journal 2007;1(1):12-6.

Jeon IH, Oh CW, Kim SJ, Park BC, Kyung HS, Ihn JC. Minimally invasive percutaneous plating of distal femoral fractures using the dynamic condylar screw. J Orthop Trauma. 2004;57(5):1048-52.

Danziger MB, Caucci D, Zecher SB, Segal D, Covall DJ. Treatment of intercondylar and supracondylar distal femur fractures using the GSH supracondylar nail. Am J Orthop. 1995;24:684–90.

Firoozbakhsh K, Behzadi K, DeCoster TA, Moneim MS, Naraghi FF. Mechanics of retrograde nail versus plate fixation for supracondylar femur fractures. J Orthop Trauma. 1995;9:152–7.