Analysis of management of supracondylar femur fracture by locking compression plate

Abstract

Background: Supracondylar fractures of femur present a huge surgical challenge. The introduction of locking compression plate (LCP) has brought a remarkable change in the management of supracondylar fractures of distal femur. Aim: The aim of this study was to evaluate the rate of union, functional outcome and complications of these fractures treated with open reduction and internal fixation with a locking compression plate. Materials and method: The present study was conducted in the Department of Orthopedics, RIMS, Ranchi during June 2014 to December 2015. A 40 adult patients with closed supracondylar fractures of distal femur (Muller Type-A) and treated by locking compression plate were included in this study. Variables of each patients were recorded and analyzed with respect to age, sex, fracture type, mode of injury, limb involvement, associated injuries, timing and duration of operation, duration of hospital stay in days, follow up, complications and final outcomes. Patients were evaluated both clinically as well as radiologically at 6 weeks interval for first 6 months, then every 3 months for next 6 months and then at every 6 months. Results: The mean age of patients was 27.50 yrs. Out of 40 patients, 26 (65%) were male and 14 (35%) were female. The right femur was involved in 22 (55%) patients, and left in 16 (40%) patients while both femur was involved in only 2 (5%) patients. Clinical union was seen at 12.65 weeks (10-30 weeks) in all cases. Radiologically bridging callus was seen at 12th post-operative week and complete radiological union at a mean time of 25.73 weeks (20 - 40 weeks). 34 (85%) patients had excellent, 4 (10%) patients had good outcome and 2 (5%) patients had failure in the final result. Conclusion: Locking compression plate fixation is a safe procedure for supracondylar fractures of distal femur with an excellent functional outcome, early clinical and radiological union and it can be done on a routine basis with a minimum risk of complications.