Abstract
OBJECTIVE: Evaluate safety and reliability of internal fixator for the treatment of intra-articular and periarticular distal femur fractures. METHODS: Retrospective data evaluation of 28 patients with 29 fractures fixed with internal fixator was performed. There was a predominance of male patients (53.5%), with 52% of open wound fractures, 76% of AO33C type fractures, and a mean follow up of 21.3 months. Time of fracture healing, mechanical axis deviation, rate of infection and postoperative complications were registered. RESULTS: Healing rate was 93% in this sample, with an average time of 5.5 months. Twenty-seven percent of patients ended up with mechanical axis deviation, mostly resulting from poor primary intra-operative reduction. There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. Healing rate in this study was comparable with current literature; there was a high degree of angular deviation, especially in the coronal plane. CONCLUSION: Internal fixators are a breakthrough in the treatment of knee fractures, but its use does not preclude application of principles of anatomical articular reduction and mechanical axis restoration. Level of Evidence II, Retrospective Study.
Highlights
Patients with distal femur fractures (AO 33-A or 33-C) treated with LISS® plate from April 2002 to December 2008 were included in this study
There was resolution after new osteosynthesis with absolute stability technique and replacement of the implant by a DCS® (Dynamic Condylar Screw, Synthes) plate. Another case underwent bone grafting with internal fixation after 10 months of fracture, and is currently at two months postoperatively awaiting consolidation, showing good evolution
In the radiographic evaluation of patients we identified that malalignment of the femur was caused by two factors: firstly because of failed initial reduction, which is related to the difficulty of implant placement
Summary
Bruno Bellaguarda Batista[1], Rodrigo Salim[1], Cleber Antonio Jansen Paccola[2], Mauricio Kfuri Junior[1]
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