Minimally  invasive plate osteosynthesis  of  lower  end  of femur  fractures  using  locking compression  plating: a prospective  study

Raghu Kumar J.; Prasanna Anaberu; Vinit M. Oswal

doi:10.18203/issn.2455-4510.IntJResOrthop20173939

Authors

Raghu Kumar J. Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India
Prasanna Anaberu Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India
Vinit M. Oswal Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20173939

Keywords:

Supracondylar femur fracture, LCP, MIPO, Open reduction internal fixation, Intraarticular fractures, Neer’s scoring system

Abstract

Background: The treatment of distal femur fractures has recently evolved towards indirect reduction and minimally invasive techniques. The goal is to strike a balance between the mechanical stability of the fragments and the biological viability. Pre-contoured Locking compression plates (LCPs) have shown to give best results in terms of recovery, fracture union, return to work and functional outcome. Advent of MIPO technique has reduced the amount of soft tissue injury, delayed healing, tissue necrosis and infections.The objective was to study the functional result of fracture distal femur treated by closed reduction with LCP by minimally invasive plate osteosynthesis (MIPO).

Methods: 20 cases of fracture distal end of femur were treated by closed reduction and internal fixation using LCP by MIPO between 1st October 2013 to 30th September 2015 at our centre. The patients were evaluated clinically and radiologically for functional outcomes. All patients were followed up for an average of 12 months. Outcome was assessed using NEER’s score.

Results: 8 of my patients were male and 12 were female. All of them were closed injuries and fresh cases. The mean age was 51.8 years (21-68 yrs). 13 patients sustained RTA and 7 patients had accidental fall. 8 patients had right sided distal femur fracture and 12 had left sided injury. According to NEER’s score 50% had excellent results, 35% had good results and 15% had fair results. Gait and weight bearing after union was satisfactory. Range of motion of knee joint in majority of patients was within acceptable limits.

Conclusions: Closed reduction and internal fixation of fracture lower end of femur by MIPO using LCP is one of the best modalities of treatment for good results.

Metrics

Metrics Loading ...

Author Biographies

Prasanna Anaberu, Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India

DEPARTMENT OF ORTHOPAEDICS ,PROFESSOR

Vinit M. Oswal, Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India

Department of orthopaedics , Post graduate MS Resident

References

Ehlinger M, Adam P, Abane L, Arlettaz Y, Bonnomet F. Minimally-invasive internal fixation of extra-articular distal femur fractures using a locking plate: Tricks of the trade. Orthop Traumatol Surg Res. 2011;97(2):201–5.

Ehlinger M, Dujardin F, Pidhorz L, Bonnevialle P, Pietu G, Vandenbussche E. Locked plating for internal fixation of the adult distal femur: Influence of the type of construct and hardware on the clinical and radiological outcomes. Orthop Traumatol Surg Res. 2014;100(5):549–54.

Kregor PJ, Stannard JA. Treatment of Distal Femur Fractures Using the Less Invasive. J Orthop Trauma. 2004;18(8):509–20.

Syed AA, Agarwal M, Giannoudis P V, Matthews SJE, Smith RM. Distal femoral fractures : long-term outcome following stabilisation with the LISS. Injury. 2004;35(3):599–607.

Schutz M, Muller M, Regazzoni P, Hontzsch 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;125:102–8.

Markmiller M, Konrad G, Südkamp N. Femur – LISS and Distal Femoral Nail for Fixation of Distal Femoral Fractures. Clin Orthop Relat Res. 2004;(426):252–7.

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 Suppl 3:SC32-47.

Fankhauser F, Gruber G, Schippinger G, Boldin C, Hofer H, Grechenig W, et al. 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):55-60.

Ehlinger M, Adam P, Arlettaz Y, Moor BK, DiMarco A, Brinkert D, et al. Minimally-invasive fixation of distal extra-articular femur fractures with locking plates: Limitations and failures. Orthop Traumatol Surg Res. 2011;97(6):668–74.

Weight M, Collinge CM. Early Results of the Less Invasive Stabilization System for Mechanically Unstable Fractures of the Distal Femur AO / OTA. J Orthop Trauma. 2004;18(8):503–8.

Buckley R, Mohanty K, Malish D. Lower limb malrotation following MIPO technique of distal femoral and proximal tibial fractures. Injury. 2011;42(2):194–9.

Kolb W, Guhlmann H, Windisch C, Marx F, Kolb K, Koller H. Fixation of distal femoral fractures with the Less Invasive Stabilization System: a minimally invasive treatment with locked fixed-angle screws. J Trauma. 2008;65(6):1425–34.

Khursheed O, Wani MM, Rashid S, Lone AH, Manaan Q, Sultan A, et al. Results of treatment of distal extra: articular femur fractures with locking plates using minimally invasive approach--experience with 25 consecutive geriatric patients. Musculoskelet Surg. 2014;99(2):139–47.

Smith TO, Hedges C, MacNair R, Schankat K, Wimhurst JA. The clinical and radiological outcomes of the LISS plate for distal femoral fractures: A systematic review. Injury. 2009;40(10):1049–63.

Krettekl C, Miillerz M, Miclaus T, Francisco S, Francisco S, Hospital G, et al. iNTEZNllW JamAL N CA @ cc. Int J care Inj. 2001;32(3):14–23.

Malik AL, Siddique M, Niazi NS, Niazi SNK. Outcome of locking compression plate in supracondylar fracture of distal femur by minimally invasive plate osteosynthesis. Pakistan J Med Heal Sci. 2015;9(1):31–3.

Locked Compression Plating for Peri- and Intra-articular Fractures Around the Knee. Department of orthopaedics, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India. 2013

El-Ganainy AR, Elgeidi A. Treatment of distal femoral fractures in elderly diabetic patients using minimally invasive percutaneous plating osteosynthesis (MIPPO). Acta Orthop Belg. 2010;76(4):503-6.

Necmioglu NS, Subasi M, Kayikci C. Minimally invasive plate osteosynthesis in the treatment of femur fractures due to gunshot injuries. Acta Orthop Traumatol Turc. 2005;39(2):142-9.

Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique. J Orthop Trauma. 1999;13(6):401-6.

Yeap EJ, Deepak AS. Distal Femoral Locking compression Plate fixation in Distal Femoral Fractures: Early results. Malaysian Orthop J. 2007;1(1):12-7.

Close reduction by manipulation and minimally invasive percutaneous plate osteosynthesis for the treatment of supracondylar femur fractures. Orthopaedics Hospital of Sichuan, Chengdu 610041, Sichuan, China, 2011.

Doshi HK, Wenxian P, Burgula MV, Murphy DP. Clinical outcome of distal femoral fracture in the geriatric population using locking plates with a minimally invasive approach. Geriatr Orthop Surg Rehabil. 2013;4(1):16–20.

Mast J, Jakob R, Ganz R. Planning and reduction techniques in fracture surgery. New York: Springer-Verlag;1989.

Nayak RM, Koichade MR, Umre a N, Ingle MV. Minimally invasive plate osteosynthesis using a locking compression plate for distal femoral fractures. J Orthop Surg (Hong Kong). 2011;19(2):185–90.