Distal Femur Fractures Treated by MIPO Locking Compression Plate – A Prospective Study on the Functional Outcome

Abstract

Introduction: Fractures of distal femur are one of the complex injuries that are encountered in our day-to-day practice with the incidence of about 37% in 100,000 people. These injuries have potential to generate significant long-term disability particularly when they are related with marked bone comminution, extensive articular cartilage damage and severe soft tissue injury. Several treatment options are available for the treatment of these injuries but with less predictable outcome. Objectives: The aim of the present study is to assess the functional outcomes of Minimally Invasive Precutaneous Plate Osteosynthesis (MIPO) for distal femur fractures. Materials & Methods: In the present prospective study, 23 patients with distal femur fractures in adult were treated using locking compression plate and MIPO technique. The patients were selected from Mahatma Gandhi Medical College and Research Institute, Pondicherry. Rasmussen’s scoring system was used for evaluating the functional assessment, focused on Clinical and radiological parameters. In this system, there are scoring points for subjective complaints, clinical signs, available range of motion and stability. Results: The analysis was done in terms of gender, age group, Mode of injury, frequency and type of injury, surgical intervention and complication. Majority of the injured patients were male (56.5%). Among male patients 73.3 % of the injury was due to road traffic accidents, whereas among females majority of them were injured due to domestic fall. Common age group was found to be 41-60 years accounting 39%. All fractures in our patients went on to unite and the average union time was about 16 weeks with the range of 12 to 20 weeks. Of 23 patients only one patient had restricted ROM of about 70* and all the other patients had ROM of about 110* - 130*. Two patients had limb shortening of 5-8 mm. Functional outcome was assessed using Rasmussen’s scoring and we had excellent and good results in 15 (65%), 8 (35%) patients respectively. No poor results in our series. Conclusion: This study evaluated the results of radiological union and functional outcomes of distal femoral fracture treated by LCP MIPO. The operative interval was lesser with decreased loss of blood, fractures healed rapidly with no significant complications. MIPO gives better results when comparing other techniques but requires special attention to master the technique thereby prevent the complications.