Functional outcome of fixation of distal femoral fractures with DF-LCP: a prospective study

Abstract

INTRODUCTIONFractures of the distal femur are complex injuries that can be difficult to manage. They are serious injuries having the potential to produce significant long-term disabilities. Distal femoral fractures are much less common than hip fractures and account for about 7% of all femoral fractures. If fractures of the hip are excluded, 31% of femoral fractures involve the distal portion.1 These fractures are defined as those fractures involving the distal 15 cm of the femur including the metaphysis and/or the articular surface. Because of severe soft tissue damage, extensive comminution, intrarticular extension and injury to quadriceps mechanism, the management of these fractures has presented significant challenge to orthopaedic surgeons since the beginning of this speciality. However, for proximal fractures of femur, orthopaedic literature is embellished with extensive experience with specific methods. The distal femur is not well suited for internal fixation. A widening canal, thin cortex and poor bone stock make open reduction in this area a great challenge. Watson Jones noted that "Few injuries present more difficult problems than supracondylar fracture of the femur". Studies done in the 1960s documented better outcomes for patients treated non-operatively than for those treated ABSTRACT Background: Management of supracondylar fractures is a real challenge to the orthopaedician due to its extensive soft tissue injury, boneloss, comminution, articular extention and instability. Open reduction and internal fixation with anatomical distal femoral locking plate permits early mobilization. Stable anatomical fixation is necessary to avoid complications and disability. Methods: 25 patients with Type A and Type C closed supracondylar femoral fractures were followed up from November 2013 to November 2015. All the patients underwent ORIF with DF-LCP. Clinical and radiological follow up were recorded for 24 months. Results: Mean time for fracture union was 4.02 months. Average duration for full weight bearing was 122 days (range 90-180days). The average range of movement for Type A fractures was 105.71 degrees, for C fractures average ROM was 93.64 degrees. Average ROM for patients <50 was 103 degree and for patients>50 ROM was 98.66 degree. Conclusions: Locked plating of DF fractures permits stable fixation and early mobilization which avoids disability and ensures good joint function.