Management of distal femur fractures with locking compression plate: a prospective study

Authors

  • Sridhar Reddy Konuganti Department of Orthopedics, Maheshwara Medical College & Hospital, Chitkul(V),Patancheru,Medak District,Telangana State,India-503207
  • Sreenath Rao Jakinapally Department of Orthopedics, Maxcure hospital, Sarovar Complex, Secretariat Road, Saifabad, Telangana State, India
  • Vennamaneni Pratish Rao Department of Orthopedics, Government Medical college and Hospital , Siddipet, Telangana State,India
  • Sivaprasad Rapur Mediciti Institute of medical sciences, Ghanpur, Medchal, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20180459

Keywords:

Distal femur fractures, Locking compression plate, Neer’s functional score, Muller’s classification

Abstract

Background: Distal femur fractures need to be treated operatively to achieve optimal outcomes. Different types of internal fixation devices have been used but, the number of revisions for non-union, loss of reduction and implant failure has been high.

Methods: This prospective study reviewed 20 cases of distal femoral fractures surgically managed with distal femoral locking compression plate between December 2013 and December 2015 at Mediciti Institute of medical sciences, Ghanpur, Medchal, tertiary care referral and trauma centre. Fractures were categorized according to OTA classification by Muller.

Results: Highest number of patients was in their 3rd decade (25%) 18 out of 20 patients had closed injury. Type A2 Muller’s fracture was the most common fracture type 7 out of 20 patients (35%).The mean follow up period in this study was 8 months. The average range of knee flexion achieved was about 109°. The mean score 81.75 points were rated using Neer’s functional score (Max 100).

Conclusions: The locking compression plate is the treatment of choice in the management of comminuted distal femoral fractures especially Type A fractures where we have found higher Neer scores. It may not completely solve the age-old problems associated with any fracture like non-union and malunion, but is valuable in the management of these fractures.

 

Author Biographies

Sridhar Reddy Konuganti, Department of Orthopedics, Maheshwara Medical College & Hospital, Chitkul(V),Patancheru,Medak District,Telangana State,India-503207

Senior Resident, Department of Orthopaedics, Maheshwara medical college

Sreenath Rao Jakinapally, Department of Orthopedics, Maxcure hospital, Sarovar Complex, Secretariat Road, Saifabad, Telangana State, India

Registrar, Department of Orthopedics

Vennamaneni Pratish Rao, Department of Orthopedics, Government Medical college and Hospital , Siddipet, Telangana State,India

Senior Resident,Department of Orthopedics

Sivaprasad Rapur, Mediciti Institute of medical sciences, Ghanpur, Medchal, Telangana, India

Head of  Department, Department of Orthopedics

References

Kolmert L, Wulff K. Epidemiology and treatment of distal femoral fractures in adults. Acta Orthop. Scand. 1982;53:957–62.

Martinet O, Cordey J, Harder Y, Maier A, Buhler M, Barraud GE. The epidemiology of fractures of the distal femur. Injury. 2000;31(3):62–3.

Sanders R, Swiontowski. Double plating of comminuted unstable fractures of distal part of femur. JBJS. 1991;730:341-5.

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

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.

Neer CS II, Grantham SA, Shelton ML. Supracondylar Fracture of the Adult Femur – A Study of One Hundered and Ten Cases. JBJS Am. 1967;49(4):591-613.

Henderson CE, Kuhl LL, Fitzpatrick DC. Healing Complications Are Common After Locked Plating for Distal Femur Fractures. Clin orthop Relat Res. 2011;469:1757-65.

Markmiller M, Konrad G, Sudkamp N. Femur-LISS and distal femur nail for fixation of distal femoral fractures. Clin Orthop and Relat Res. 2004;426:252-7.

Weight M, Collinge C. Early results of the less invasive stabilization system for mechanically unstable fractures of the distal femur. J Orthop Trauma. 2004;18:503-8.

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(3):32-47.

Gaines RJ, Sanders R, Sagi HC, Haidukewych GJ. Titanium versus stainless steel locked plates for distal femur fractures: is there any difference? OTA abstract. 2008;55:8.

Kayali C, Agus H, Turgut A. Successful results of minimally invasive surgery for comminuted supracondylar femoral fractures with LISS: comparative study of multiply injured and isolated femoral fractures. J Orthop Sci. 2007;12:458–65.

Fankhauser F, Gruber G, Schippinger G, Boldin C, Hofer HP, 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):56-60.

Vallier HA, Hennessey TA, Sontich JK, Patterson BM. Failure of LCP condylar plate fixation in the distal part of the femur-A report of six cases. J Bone J Surg Am. 2006;88(4):846- 53.

Schutz M, Muller M, Krettek C, Hontzsch 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):48-54.

Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18(8):488–93.

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 to 2005). J Orthop Trauma. 2006;20(5):366-71.

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

Sommer C, Babst R, Muller M, Hanson B. Locking Compression Plate Loosening and Plate Breakage – A Report of Four Cases. J Orthop Trauma. 2004;18(8):571-7.

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Published

2018-02-23

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Original Research Articles