Study of functional outcome of muller type C distal femur fracture treated with locking compression plate
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20232611Keywords:
Distal femur fracture, LCP, Knee range of movement, Neer’s scoring system, Muller classificationAbstract
Background: To evaluate the functional outcome of Muller type C distal femur fracture treated with locking compression plate (LCP).
Methods: This prospective study was carried out at Al-Ameen medical college and hospital, Vijayapura. Forty patients (24 males and 16 females) with Muller type C distal femur fractures were enrolled in our study. Patients were treated with open reduction and internal fixation with LCP. They were followed up for 9 months with clinical examination and serial x-rays. The functional outcome was evaluated using Neer’s scoring system.
Results: Forty patients who completed follow up of 9 months were included. There were 18 muller type C1, 14 muller type C2 and 8 Muller type C3 fractures. The functional evaluation with Neer’s scoring system was excellent in 8 patients, good in 20 patients, fair in 8 patients and poor in 4 patients. Complications observed were difficulty in reduction, superficial infections, knee stiffness and limb length discrepancy.
Conclusions: The LCP is a safe and effective tool to manage these difficult fractures as we had no incidence of implant failure, delayed union, non-union and revision surgery except that we had knee stiffness as commonest complication which can be tackled by early surgery, surgical expertise, meticulous soft tissue handling and vigorous early knee mobilisation.
References
Arneson TJ, Melton LJ 3rd, 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.
Brett D, Crist MD, Gregory J, Della R, Yvnne M. Treatment of acute distal femur fractures. Orthopedics. 2008;31(7):681-90.
Schandelmaier P, Partenheimer A, Koenemann B. Distal femoral fractures and LISS stabilization. Injury. 2001;32(3):SC55-63.
Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ. Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989-2005). J Orthop Trauma. 2006;20:366-71.
Kolmert L, Wulff K. Epidemiology and Treatment of Distal Femoral Fractures in Adults. Acta Ortho Scand. 1982;53:957-62.
Mize RD, Bucholz RE, Grogan DP. Surgical treatment of displaced, comminuted fractures of distal end of femur. JBJS Am. 1982;64-A(6):871-9.
Heather V, Theresa H, John S. Failure of LCP condylar plate fixation in the distal part of the femur. J Bone Joint Surg. 2006;88-A:846-53.
Enneking WF, Marshall Horowitz. The intraarticular effect of immobilization on the human knee. JBJS. 1972;54-A(5):973-85.
Kregor PJ, Stannard J, Zlowodzki M, Cole PA, Alonso J. Distal femoral fracture fixation utilizing the Less Invasive Stabilization System (L.I.S.S.): the technique and early results. Injury. 2001;32:32-47.
Schütz M, Müller M, Regazzoni P, Höntzsch D, Krettek C. Use of the Less Invasive Stabilization System (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Arch Orthop Trauma Surg. 2005;125:102-8.
Müller ME, Nazarian S, Koch P. Classification AO des fractures. Tome I. Les OS longs. Berlin: Springer-Verlag. 1987.
Müller ME, Nazarian S, Koch P. The Comprehensive Classification of Fractures of Long Bones. New York: Springer-Verlag. 1990.
Kregor PJ, Stannard JA, Zlowodzki M. Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma. 2004;18:509-20.
Schütz M, Müller M, Krettek C, Höntzsch D, Regazzoni P, Ganz R et al. Minimally invasive fracture stabilization of distal femoral fractures with the LISS: a prospective multicenter study. Results of a clinical study with special emphasis on difficult cases. Injury. 2001;32(3):SC48-54.
Yeap EJ, Deepak AS. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results. Malaysian Orthop J. 2007;1(1):12-7.
Apostolou CD. Preliminary results and technical aspects following stabilisation of fractures around the knee with LISS Injury. 2005;1.