Minimally invasive plate osteosynthesis for distal femur fractures.

Introduction:Distal femoral fractures in elderly population had recorded an increase in incidence in the last 2 decades. Lateral distal femoral locking plating is considered one of the best options especially when dealing with comminuted fractures but varus collapse of the medial femoral condyle occurs frequently in patients with osteoporosis. Anatomical reduction of the fracture with stable rigid fixation using double-plating approach allows early mobilization of geriatric population and prevents varus collapse minimizing the comorbidities in such fractures.Patients and Methods:Between September 2014 and January 2017, a prospective study on 23 patients with comminuted osteoporotic distal femoral fractures managed through the double-plating approach through a single parapatellar approach has been conducted. Only osteoporotic geriatric patients with isolated distal femoral fractures were included. Polytraumatized, open fractures, and fracture type 33-A1, 33-A2, and 33-B were excluded. The mean age was 69.6 years (61-80). All patients have been evaluated as regard duration of procedure, time to union, EQ-5D-5L score, the need of autologous bone grafts, range of knee motion, and presence of complications.Results:The average follow-up was 14.1 months. The majority of fractures were type 33-C2 (13 patients). Average procedure time was 148 minutes (117-193 minutes). Mean EQ-5D-5 L score was 83.8 (72-82). Average time to union was 9 months (3-12 months). Four (17.4%) cases needed autologous bone graft after 6 months. No loss of reduction in any of the cases was evident, although 6 (26%) cases had screw breakage or cutout in one of the plate fixation. Two (8.7%) patient developed superficial wound infection and 1 (4.3%) developed DVT.Discussion:This study aimed at evaluation of the success of double plating of distal femoral fractures in geriatric population. different fixation methods were studied for reduction and fixation of such a fracture such as external fixation, intramedullary nails and lateral plating. the quality of fracture reduction, functional and radiological outcomes, time to union, the need for bone grafting and complication are the main debatable issues.Conclusion:Single-incision double-plating approach for distal femoral osteoporotic fractures is effective and provides stable construct without reduction loss allowing early rehabilitation. Delayed union and the need for bone graft are the major drawbacks for this technique.

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“…This rate is incomparable to the current study and other studies using the double-plating technique, which is 9 months. 39 , 40 …”

Section: Discussionmentioning

confidence: 99%

Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures

Metwaly

Zakaria

2018

Geriatr Orthop Surg Rehabil

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Functional Outcomes of Intra Articular Distal End Femur Fractures Treated with Locking Compression Plating

et al. 2022

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Background: Distal femur fractures represent 4-6% of all the femoral fractures and they occur within the 9 terminal centimeters. Most distal femur fractures are the result of a severe axial load with a varus, valgus or rotational force. Though various treatment options are available for the management of these injuries with their own advantages and disadvantages, treatment of these fractures with the angle stable constructs using Locking compression plating remains the most desirable treatment option. Objectives: To study the functional outcomes and complications of intra-articular distal end femur fractures treated with Locking Compression Plating. Materials and Methods: A prospective observational study was conducted over a period of 3 years on 47 patients requiring operational intervention for distal end femur fractures. Results: We studied different parameters like age of the patients, mode of injury, type of injury according to AO classification, duration of hospitalization, movement of knee after operation, Neer’s score results, union or non-union and compared our studies with other studies we find satisfactory results in our study in outcome of the patient As per the Neer’s knee score, excellent and good outcome was seen in 48.9% and 38.3% cases while fair and poor outcome was seen in 8.5% and 4.3% cases respectively. Conclusion: From our study we concluded that Distal femoral-LCP, the “internal fixator” was a safe and reliable implant although careful preoperative planning and case selection were important factors which determine the final outcome.

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Minimally invasive plate osteosynthesis for distal femur fractures.

Cited by 2 publications

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Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures

Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures

Functional Outcomes of Intra Articular Distal End Femur Fractures Treated with Locking Compression Plating

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