Analysis of management of supracondylar femur fracture by locking compression plate

Abstract

Background: Open fractures of tibial shaft are important for the reason that they are most commonly fractured long bone in the body & subcutaneous location of the anteromedial surface of the tibia makes their management controversial. The precarious blood supply and lack of soft tissue cover of the shaft of the tibia make these fractures vulnerable to delayed union, nonunion, malunion and infection. The treatment of tibial fractures has developed from a strictly non-operative to a variety of operative techniques. While reamed Intramedullary nailing offer improved stability of the fracture, their use carries a theoretical risk of infection and nonunion as a consequence of disturbing endosteal blood supply. Recent reports suggest that the reaming is safe for grade I, II and IIIA open fractures of tibia. Material & Method: A total of 25 patients presented to Father Muller Hospital, Mangalore from Jan'06 to July'07 with type I and II open tibial shaft fractures were included in the study and all cases underwent debridement within 6 hours of admission and treated with reamed intramedullary interlocking nailing. They were reviewed at every 2 weeks for 6 weeks and then monthly post operatively and x-rays were repeated at 6,12,24 weeks to check for fracture healing. The average duration of follow-up was 32 weeks. Functional results were graded according to criteria by klemm & borner. Result:The average time to union was 19.68 weeks. Type I united in 18.86 weeks as compared to 20.5 weeks for Type II fractures. The average range of motion in the knee joint was 135.6 degrees. Full ankle motion was observed in 19 patients. One patient showed a loss >25° of motion at ankle compared to normal side while 5 patients showed < 25 0 loss of joint motion. 92% patients achieved good or excellent results, fair results were obtained in one patient & in one patient functional results were poor. Conclusion: Anatomical & functional outcome of open tibial fractures type I and type II treated with reamed intramedullary interlocking nailing is excellent to good and it is safe and effective technique for the management of Gustilo type I and type II.

Competency of distal femur locking plate as an answer for fixation of all varieties of distal femur fractures

“…Considering complex nature of this injury the prognostic factors described in distal end femur fracture are age, intraarticular extension of the fracture, comminution, open/closed fracture, early physiotherapy and surgeon's expertise. [4][5][6][7] We used locking distal femur plates which has advantage of locking screws into the plate and whole implant behaves as single solid angular stable construct. The "combi holes" in this plate offers advantage of applying cortical screws in compression mode and locking screws in locking mode that preserves blood supply of the periosteum.…”

Outcomes of Surgical Management of Distal Femur Fracture with Distal Femoral Locking Compression Plate at Koshi Zonal Hospital

“…Distal femur fracture reconstruc on needs a very skillful hand because it's a very challenging procedures for the orthopedic surgeons. The goal of the reconstruc on is not only the anatomical reduc on of the ar cular surface but also the adequate stabiliza on of the fracture and early mobiliza on along with preven on of the s ffness and early ambula on of the pa ent.The prognos c factors described for distal femur fracture are age, fracture types, ar cular involvement, proper implant selec on, ming of joint mo on and [12][13][14][15] surgeon's exper se. The outcomes of DF-LCP in distal femur correlated with the fracture severity, e ology, anatomic reduc on, bone quality, length of me elapsed from injury to surgery, concomitant injuries and proper posi oning and fixa on of the implant.…”

“…All pa ents started isometric hamstring, gluteal and quadriceps exercises as taught by the nd physiotherapist on the 2 post-opera ve day and was con nued ll full range of movement of knee was achieved. Pa ents were on intravenous an bio cs a er surgery for (5-7) days depending upon wound condi ons which was switched to oral an bio cs ll suture removal (range [12][13][14] days. Dura on of hospital stay was average 12 (range 10-19) days.…”

Evaluation of functional outcome in patients treated with locking compression plate for distal femur fractures

“…Patients with fractures of distal end femur (distal 15cm) admitted to JMMC orthopedics department were taken up for the study after taking the required consent, from December 2017 to may 2019 (18 months) A pre structured and pre tested functional evaluation scoring system-NEER'S SCORING SYSTEM 4 was used to assess the functional outcome. Based on the prevalence of functional outcome observed in earlier publications 5 , with 95% confidence level and 20% relative allowable error minimum sample size was 17. But a total of 20 samples are taken up for this study.…”