Abstract
BackgroundTreatment of supraintercondylar (AO/OTA 33-C) and supracondylar (AO/OTA 33-A) femur fractures is generally challenging. Standard treatments include open reduction and internal fixation. However, optimal implants are now being well-defined. This study focus on the comparison between clinical and functional outcomes of fractures treated with condylar buttress plates (CBPs).MethodsWe treated 87 patients with supraintercondylar or supracondylar femur fracture from 2004 to 2008, including 30 supraintercondylar and 24 supracondylar fractures treated with CBPs. Both knee and function scores (per Knee Society) were given to clinical and functional outcomes, and concomitant knee function was assessed per Mize criteria. ResultsUnion rate of supraintercondylar fractures was 90 % (27/30) and supracondylar fractures was 91.7 % (22/24) (P = 0.68). In supraintercondylar group, 16.7 % revealed postoperative varus deformity, whereas none in supracondylar group (P = 0.045). Knee Society knee score was 73.6 in supraintercondylar group and 85.5 in supracondylar group (P = 0.009); and function score was 62.5 in supraintercondylar group and 83.1 in supracondylar group (P = 0.023). A satisfactory result based on modified Mize criteria was achieved in 50 % of supraintercondylar fractures and in 79.1 % of supracondylar fractures (P = 0.09).ConclusionsUse of CBPs for supraintercondylar and supracondylar femur fractures treatment led to a high union rate. However, a high rate of varus deformity occurred in patients with supraintercondylar but not supracondylar fractures. Moreover, CBP treatment in patients with supracondylar fractures led to better functional outcomes than those with supraintercondylar fractures.
Highlights
Treatment of supraintercondylar (AO/OTA 33-C) and supracondylar (AO/OTA 33-A) femur fractures is generally challenging
In 1960s, in a series of 213 cases, Stewart and colleagues compared surgical and conservative treatment of distal femur fractures and concluded that Kirschner pin traction was recommended as the treatment of choice, with higher acceptable results than with open reduction and internal fixation (ORIF) [1]
In 1970s, Arbeitsgemeinschaft für Osteosynthesefragen (AO) reported good or excellent results in 74 % of 112 supracondylar femur fractures treated with a condylar plate
Summary
Treatment of supraintercondylar (AO/OTA 33-C) and supracondylar (AO/OTA 33-A) femur fractures is generally challenging. Standard treatments include open reduction and internal fixation. Owing to improvements in surgical techniques and modern implant designs, open reduction and internal fixation (ORIF) is thought to be the standard treatment by many orthopedic surgeons. In 1960s, in a series of 213 cases, Stewart and colleagues compared surgical and conservative treatment of distal femur fractures and concluded that Kirschner pin traction was recommended as the treatment of choice, with higher acceptable results than with ORIF [1]. In 1970s, Arbeitsgemeinschaft für Osteosynthesefragen (AO) reported good or excellent results in 74 % of 112 supracondylar femur fractures treated with a condylar plate. Studies by Schatzker and colleagues [3] reported good or excellent results in 73.5–75 % patients following ORIF. He emphasized the importance of early motion and stable fixation. Plate systems are the favored method of treatment, including condylar buttress plates (CBPs), Weng et al BMC Musculoskeletal Disorders (2016) 17:413 dynamic condylar screws, fix-angle condylar plates, and locking plates [3,4,5,6,7,8,9,10,11,12]
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