A Prospective Study of Femur Lower End Fractures, Management by LCP Using Mippo Technique

Abstract

BACKGROUND: Distal femur fractures are commonest fractures in high velocity trauma, the records of a consecutive series, from 1969 to 1976, of 135 adult patients with 137 fractures of which Eight-three fractures were caused by moderate and 52 by severe trauma. 1 Isolated fractures can lead to complications such as ARDS and pulmonary embolism. This leading to the need for early stabilization of fractures, with internal fixation being the choice of treatment for distal femur fracture by LCP. Plating has given the best results in terms of recovery, fracture union, return to work and in turn the functional outcome. OBJECTIVES: To study the functional outcome of the distal femur fracture fixation using LCP with MIPPO technique. METHODS: The surgical outcome of 30 patients (24 males and 6 females) who were treated by closed reduction with locking compression plate using MIPPO technique, were followed for an average of 12 months, then by radiological and clinical evaluation assessment was done using the NEER'S score. RESULTS: In the study of 30 patients with acute trauma, median age being 45 years ranging from 22-68 years. 22 fractures were caused due to RTA, 6 of them with self-fall and 2 presenting with assault. 23 amongst them were fractures of the right femur and the rest being the left. Using the NEER'S scoring system 50% excellent results were obtained, with 30% good, 20% fair results. Range of motion of hip and knee was well preserved with excellent to good results. Gait and weight bearing after complete union was satisfactory. CONCLUSION: Closed reduction and internal fixation of the distal femur fractures by LCP using MIPPO technique is one of the best modalities of treatment, with the extension of fractures into the articular congruencies, maintaining of the same is very vital. Fixation with locking condylar plates proved to be very effective especially in severe osteoporosis, decrease in the duration of hospital stay was also seen along with faster recovery, earlier union rates and good functional outcome compared to alternative procedures known. KEYWORDS: Supracondylar femur fracture, locking condylar plate, MIPPO technique, intra-articular fractures, NEER's scoring system, closed reduction and internal fixation. INTRODUCTION:With the increase of RTA and industrialization many young lives have crippled and need for decreasing their morbidity is gaining demand.Fractures of the distal end of the femur are often difficult to treat due to their complexity and intra articular involvement at times and their associated complications.In the early 1960's, there was a great reluctance towards the operative intervention of these fractures as they were associated with higher rates of malunion, non-union, sepsis, inadequate fixation, lack of proper tools and so on. Then the traditional management of supra condylar femur displaced fracture swept, mainly consisting of skeletal traction, manipulation of fracture and external immobilization in the form of casts and cast bracings. These were associated with problem...