Distal femoral fractures treated with condylar buttress plate in a West African hospital.

Abstract

The aim of this retrospective study was to present our experience using condylar buttress plate in the treatment of distal femoral fractures. Thirty-two patients underwent open reduction and internal fixation with condylar buttress plates for distal femoral fractures from October 2000 through May 2010. Patient demographics, type of fracture, treatment, complications, results achieved, and follow-up assessment were reviewed. The fractures were classified with the AO system. The functional outcome was rated according to Schatzker and Lambert criteria. There were 22 men and 10 women with an average age was 44 (range 19-87) years. The fractures were classified as A1 (n=7; 21.8%), A2 (n=4; 12%), A3 (n=5; 15.6%); C1 (n=4; 12.5%), C2 (n=6; 18.8%), and C3 (n=6; 18.8%). The mean delay from injury to operation was 15 (range 1-27) days. Iliac bone graft was performed in four patients. Postoperatively, a posterior splint or a plaster cast was applied for 3 weeks. No patient had an intra-articular step-off of more than 2mm. Sepsis of the operative wound occurred in two patients. Fractures healed in 22 (91.7%) patients with a mean duration of 4 (range 3-8) months. Twenty-four patients were followed up on an average of 15 (range 7-28) months. Varus deformity (>10°) was observed in five (20.8%) patients. Knee flexion was less than 90° in 11 (45.3%) cases. Non-union occurred in two (8.3%) patients. Functional results were good to excellent in 11 (45.8%) patients and considered as fair or failure in 13 (54.2%). The current report also identifies varus deformity as a major concern of this implant. The main finding of this study was the ensuing knee stiffness after a prolonged immobilization and delay in performing surgery and rehabilitation program due to socioeconomic and logistic reasons.