Functional outcome of management of distal femur fractures with locking compression plate

Abstract

Distal femur fractures are difficult to manage and the selection of implant approach for internal fixation remains controversial. These fractures can be treated with either interlocking nail or locking compression plates. Locking compression Plate is one of the standard treatments for distal femoral fractures 1. There are few reports on the relationship between the screw fixation and bony union while fixing by the bridge plate (relative stability) method. The aim of this study is to evaluate functional outcome, fracture healing, and complications of distal femoral intraarticular fractures using locking compression plates. Material and methods: We reviewed 40 distal femoral fractures (type A & C – Muller classification) treated with distal femoral locking compression plates between 2019-2021. The study was conducted in SB Medical College, Hazaribag from the month of August 2019 to July 2021.There were 24 males and 16 females with mean age 35 years (Range, 25-85 years). Two different mechanisms are responsible for such trauma; high energy trauma is seen commonly in young adults and low energy or trivial trauma in the elderly and osteoporotic population. These fractures were fixed with DF-LCP with or without bone grafting where the distal femur fractures were associated with extensive bone loss. Results: Of the 40 patients, mean follow up period was 20 months (12-22 months). The mean time for radiological union was 14 weeks. (Range 12-15 weeks), except one patient which has gone for nonunion. At the latest follow up, ROM ˃ 120˚ noted in 24 patients, 90-120˚ in 11 patients and 70-90˚ in 5 patients.29 patients (72.5%) had good/excellent outcome.6 cases (15%) were fair and poor result just in 5 cases (12.5%). Conclusion: use of standard lateral approach for simple intra-articular distal femoral fractures(C1) and transarticular2/minimally invasive techniques for complex intra-articular fractures(C2/C3) results in improved exposure of the knee joint and better union rates with low incidence of bone grafting.