A prospective study on surgical fixation of complex supracondylar femur fracture with distal femoral locking compression plate: our experiences at a tertiary care centre


  • Rajesh Kumar Sharma Department of Orthopaedics, Govt. Medical College, Kota, Rajasthan, India
  • Anuradha Upadhyay Department of Physiology, S. K. Govt. Medical College, Sikar, Rajasthan, India
  • Rahul Parmar Department of Orthopaedics, Govt. Medical College, Kota, Rajasthan, India




Supracondylar, DF-LCP, Lateral approach, Schatzker and Lambert criteria


Background: The optimal treatment of complex supracondylar femur fractures remains always challenging and controversial. the purpose of this prospective study was to evaluate the efficacy of distal femoral locking compression plate (DF-LCP) in terms of functional outcome and union rate for highly unstable complex supracondylar femur fractures and to determine the influencing factors of an unfavourable outcome.

Methods: After obtaining approval from institutional ethics committee, 45 patients with complex supracondylar femur fractures were managed by open reduction and internal fixation with DF-LCP through lateral approach and as per standard protocol. The follow-up results were analysed clinically and radiologically, using the “Schatzker and Lambert criteria” at once in a month for first three months, once in three months up to one year and once in six months thereafter up to 2 years post-operatively.

Results: In the present study, average duration of radiological union was 16 (range 12-22) weeks. The average range of motion of knee joint was 105 degrees. Out of 45 patients, clinical results were excellent in 48.9%, good in 17.8%, fair in 22.2% and poor in 11.1% patients according to Schatzker and Lambert criteria. Knee stiffness (7 cases), secondary arthritis (5 cases), and non-union (4 cases) were the main complications observed in this study, which were treated accordingly.

Conclusions: DF-LCP holds the metaphyseal bone strongly and prevents metaphyseal collapse and mal-rotation in complex or highly unstable supracondylar femur fractures and simultaneously, it provides stable fixation to promote fracture union and allows early rehabilitation with acceptable complications.

Author Biography

Rajesh Kumar Sharma, Department of Orthopaedics, Govt. Medical College, Kota, Rajasthan, India

Senior Resident Doctor, department of Orthopaedics, SMS Medical college, Jaipur, Rajasthan, India


Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691-7.

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.

Schatzker J, Home G, Waddell J. (1974) The Toronto experience with the supracondylar fracture of the femur 1966-1972. Injury 1974;6:113-23.

Hoffmann MF, Jones CB, Sietsema DL, Tornetta P, Koenig SJ. Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort. J orthop surg Res.2013;8(1):43.

Whittle AP, Wood II GW. Campbell’s operative orthopaedics, Chapter 51, In: Fractures of lower extremity, 10th, Mosby Inc.2003;3.

Placide RJ, Lonner JH. Fractures of the distal femur. Curr opinion orthop. 1999;10(1):2-9.

Stewart MJ, Sisk TD, Wallace SL. Fractures of the distal third of femur. J Bone Joint Surg. 1966;48A:784-807.

Neer CS, Grantham SA, Shelton ML. Supracondylar fracture of the adult femur.J Bone Joint Surg. 1967;49A:591-613.

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.

Thomas TL, Meggit BF. A comparative study of methods for treating fractures of the distal femur. J Bone Joint Surg. 1981;63B(1):3-6.

Siliski JM, Mahring M, Hofer HP. Supracondyalar- intercondylar fracture of the femur. Bone Joint Surg. 1989;71:95-104.

Rockwood CA Jr, Green DP, Bucholz, RW. Lower extremity. In: Rockwood and Green’s fractures in adults. 8th ed. Philadelphia: Lippincott Williams & Wilkins. 2006: 2229-2268.

Schatzker J, Lambert DC. Supracondylar Fractures of the Femur. Clin Orthop. 1979;138:77-83.

Wagner M, Frenk A, Frigg R. New concepts for bone fracture treatment and the Locking Compression Plate. Surg Technol Int. 2004:12:271-7.

Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58:453-8.

Mahesh DV, Gunnaiah V. Management of Distal Femur Fracture by Locking Compression Plate. Int J Health Sci Res. 2014;4(5):235-40.

Rao LL, Kumar TD, Paleti ST, Dake SK, Raju RTK, Krishna CVM, et al. Evaluation of functional outcome after open reduction and internal fixation of distal femur fractures by locking compression plate. J Evid Based Med Healthc. 2016;3(73),3966-72.

Kubiak EN, Fulkerson E, Strauss E, Egol KA. The evolution of locked plates. J Bone Joint Surg Am. 2006;88(4):189-200.

Wagner M. General principles of clinical use of LCP. Injury. 2003;34:5-B31-42.

Siliski JM, Mahring M, Hofer P. Supracondylar-intercondylar fractures of the femur treated by internal fixation. J Bone Joint Surg. 1989;71:95-104.

Yeap EJ, Deepak AS. Distal femoral locking plate fixation in distal femoral fractures. Malaysian Orthop J. 2007;1:12-7.

Rajaiah D, Ramana Y, Srinivas K, Reddy V, et al. A study of surgical management of distal femoral fractures by distal femoral locking compression plate osteosynthesis. J Evid Based Med Healthc. 2016;3(66):3584-7.

Kim KJ, Lee SK, Choy WS, Kwon WC, Lee DH. Surgical treatment of AO type C distal femoral fractures using locking compression plate (LCP-DF Synthes). J Korean Fract Soc.2010;23(1):20-5.

Markmiller M, Konard G, Sudkamp N. femur- LISS and Distal Femoral Nail for fixation of distal femoral fractures. Clin Orthop.2004;426:252-7.

Kiran PP, Shekhar Malve, Kulkarni GS, et al. Supracondylar fracture of femur: our experience of treatment with locking compression plate from rural Maharashtra.Int J Res Orthop.2019;5(2):232-6.

Kanav Padha, Sandeep Singh, Abdul Ghani, Harish Dang. Distal Femur Fractures and its Treatment with Distal Femur Locking Plate.JK Sci. 2016:18(2):76-80.

Kregor PJ, Stannard J, Zlowodski M, Cole PA. Treatment of distal femoral fractures using Less Invasive Stabilization system. Surgical technique and early clinical results in 103 fractures. J Orthop Trauma. 2004;18(8):509-20.

Schutz M, Muller M, Regazzoni P, et al. Use of less invasive stabilization system in patients with distal femoral fractures: a prospective multicentric study. Acta Orthop Trauma Surgery. 2005;125(2):102-8.

Bolhofner BR, Carmen B, Clifford P. The results of open reduction and internal fixation of distal femur fractures using a biologic (indirect) reduction technique. J Orthop Trauma. 1996;10:372–7.

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






Original Research Articles