DOI: http://dx.doi.org/10.18203/2349-2902.isj20213214

Assessment of efficacy of locking compression plate in distal femur fractures

Faizal Ali A. A., Govind Karunakaran, Hijas Hameed

Abstract


Background: Distal femur fractures account for an estimated 6% of all femur fractures. Our study aims at evaluating the functional and radiological outcome in distal femur fractures treated with locking compression plate (DF-LCP).

Methods: Patients undergoing LCP were assessed postoperatively both functionally and radiologically. Oxford Knee Score was used to assess the functional outcome. With a maximum score of 48, a score of more than 41 is scaled as excellent, 34 to 40 as good functional status, 27 to 33 as fair and score less than 27 as poor functional result.

Results: Extra-articular fractures were the commonest (66.7%) type of fractures [simple-6.7%; metaphyseal wedge-20%; metaphyseal complex-40%] followed by complete articular fractures (26.7%) [Simple articular metaphyseal comminution-16.7%; metaphyseal and intra-articular comminution-10%] and partial articular fractures (6.7%) [Medial condyle-3.3%; coronal plane-3.3%]. Most of them had right sided femur injury (66.7%) and had history of fall (70%). Radiologically, 90% exhibited no complications and had united appropriately. Functionally the mean oxford knee score was 41.53±1.69 which ranged from a score of 38 to a maximum of 44. Highest proportion i.e., 63.3% had excellent outcome followed by good functional outcome and none showed fair or poor outcomes.

Conclusions: LCP has shown very good radiological and functional outcomes with hundred percent union of the distal femur fractures. Hence it can be used successfully in distal femur fractures.


Keywords


Locking compression plate, Distal femur fracture, Extra-articular fractures

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References


Ricci WM, Streubel PN, Morshed S, Collinge CA, Nork SE, Gardner MJ. Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases. J Orthop Trauma. 2014;28(2):83-9.

Gwathmey WF, Jones-Quaidoo SM, Kahler D, Hurwitz S, Cui Q. Distal femoral fractures: current concepts. JAAOS-J Am Academy Orthop Surgeons. 2010;18(10):597-607.

Borthakur B, Hanse B, Haque R, Jindal S, Talukdar M. Results of Locking Compression Plate fixation in Distal Femur Fractures: A Prospective Study. J Med Thesis. 2016;4(1):31-6.

Ehlinger M, Ducrot G, Adam P, Bonnomet F. Distal femur fractures. Surgical techniques and a review of the literature. Orthop Traumatol Surg Res. 2013;99(3):353-60.

Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. J Bine Joint Surg. 2007;89(10):2298-307.

Ramu AC, Roshan SD, Hedge A, Naveen A. Functional outcome of management of fracture of distal femur. National j Clin Orthop. 2018;2(1):32-6.

Toolan BC, Koval KJ, Kummer FJ, Sanders R, Zuckerman JD. Vertical shear fractures of the medial malleolus: a biomechanical study of five internal fixation techniques. Foot Ankle Int. 1994;15(9):483-9.

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.

Lee CH, Shih KS, Hsu CC, Cho T. Simulation-based particle swarm optimization and mechanical validation of screw position and number for the fixation stability of a femoral locking compression plate. Med Engineering Physics. 2014;36(1):57-64.

Hunt SB, Buckley RE. Locking plates: a current concept review of technique and indications for use. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca. 2013;80(3):185-91.

Schuetz M, Müller M, Krettek C, Höntzsch D, Regazzoni P, Ganz R, Haas N. 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;32:48-54.

Sahoo BS, Chand DK. Distal femur fracture fixation by DF-LCP-2-year experience. Int J Orthop Sci. 2017;3(1):814-8.

Jhatoth DS. Clinical and radiological outcome of distal femur fractures treated surgically with locking compression plate. National J Clin Orthop. 2019;3(1):140-6.

Pipal RK, Pipal DK, Yadav S, Pipal V, Kothari S. Results of locking compression plate in the management of fracture distal end of femur in adults. Int J Orthop. 2018;4(2):1029-33.

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 P, Partenheimer A, Koenemann B, Grun OA, Krettek C. Distal Femoral Fractures and LISS Stabilization. Injury. 2001;32:SC55-63.

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:SC24-31.

Virk JS, Garg SK, Gupta P, Jangira V, Singh J, Rana S. Distal femur locking plate: the answer to all distal femoral fractures. J Clin Diagnostic Res. 2016;10(10):RC01.

Agarwal S, Udapudi S, Gupta S. To assess functional outcome for intra-articular and extra-articular distal femur fracture in patients using retrograde nailing or locked compression plating. J Clin Diagnos Res. 2018;12(3):RC21-4.

Patel YC, Meghnathi UH, Patel VD, Hasan AN. Management of distal femur fractures with locking compression plate: A prospective study. National J Clin Orthop. 2019;3(2):105-8.

Lal AK, Kaushik SK, Gupta U, Agarwal V, Anant S. Evaluation of Results of Locking Compression Plate in Distal Femur Fractures. Int J Scientific Study. 2018;6(1):41-6.

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(6):372-7.

Fankhauser F, Gruber G, Schippinger G, Boldin C, Hofer H, Grechenig W, Szyszkowitz R. 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 Scandinavica. 2004;75(1):56-60.