Efficacy of distal femoral locking plate in treatment of distal femoral fractures

Abstract

Aim: To evaluate the efficacy of distal femoral locking plate in treatment of distal femoral fractures. Background: Distal femur fractures are one of the common fractures and constitute 1.6% of all fractures. Different treatment modalities with varying outcomes are seen in literature in the management of these fractures. Materials & methods:The study was conducted in the department of orthopaedics at tertiary Institute of Punjab. Patients treated for distal femur fractures with ORIF using distal femoral locking compression plates were evaluated to assess their clinical and functional outcome and compared with the available literature. Results: The mean time for union was less than 26 wks. Conclusion: Surgery in the form of ORIF with distal femoral locking compression plate for Distal femur fracture is a comparatively good treatment option for better out come and early mobilization with minimum complications. Keywords: Distal femur, locking plate IntroductionFractures of distal one third of femur supposedly are less than 1% of total fractures and stuck between 4%-6% of all femoral fractures. Supra condylar femoral fractures universally have bimodal distribution, younger generation caught up in high-energy trauma (including vehicular and motor-bike accidents and sports injuries) and senior citizens, often osteopenic or osteoporotic, sustaining trivial low-energy fall at home and ending up with femoral fractures [1] . Intra-articular fractures of distal femur present a tight spot to the orthopaedicians as these are easier said than done. Surgical management is usually prudent & carried out most of the times to have an advantageous end result because these are often comminuted and have their extension into the joint [2] . As orthopedic surgery has improvised over the years, methods in handling of supracondylar and intercondylar (intra articular) femur fractures now by and large engross varied surgical techniques. The aim of surgical management are to have a anatomical or near anatomical reconstruction of the articular surfaces and also to have reduction of the metaphyseal component to the diaphyseal one, restitution of normal axial alignment, length and rotation, in the last but not the least a stable internal fixation followed by early mobilisation and functional rehabilitation of the limb [3] . Internal fixation devices that used in the past and present to treat these fractures comprise of 95° angled blade plate, dynamic condylar screw plate (DCS), condylar buttress plate and retrograde supracondylar inter-locking nail. As the intricacy of these fractures has altered from simple extraarticular supracondylar types to intraarticular (inter condylar) and metaphyseal comminuted types, implants used till now may not meet the requirements. Double plating, and/or of late, locked plating (LP) technique have been advocated. But in double plating, there is often extensive soft tissue stripping on both medial & lateral sides of the femur, resulting in decreased blood supply and impending non-union and/or failure of t...