Surgical treatment of distal femoral fractures using a distal femoral locked plate versus a condylar buttress plate

Abstract

Objective The aim of the study was to evaluate the clinical and functional outcome of internal fixation of distal femoral fractures with a condylar buttress plate versus a distal femoral locked plate. Background Distal femoral fractures are serious injuries that are difficult to treat and carry an unpredictable prognosis requiring special preoperative planning and close follow-up. Surgical treatment has become the standard treatment after considerable improvement in surgical techniques and the implants used, which avoid the complications of conservative treatment. Patients and methods We conducted a randomized prospective study including 30 patients (17 men and 13 women) with distal femoral fractures who were treated by means of open reduction, internal fixation (ORIF), using a distal femoral locked plate in 15 patients and a condylar buttress plate in 15 patients. Fractures were of types A, B, and C according to the AO/ASIF classification. Patients were followed up for 6 months. The exclusion criteria included open fractures, periprosthetic fractures, and old nonunited fractures. The clinical and functional outcomes were classified according to the functional evaluation scoring system described by Sanders and colleagues . Results The functional outcome was excellent in 33.3 versus 20%, good in 46.7 versus 26.7%, fair in 13.3 versus 20%, and poor in 6.7 versus 33.3% of patients treated with the distal femoral locked plate and the condylar buttress plate, respectively. The range of motion was significantly superior in patients treated with the distal femoral locked plate. Complications were significantly fewer with the distal femoral locked plate than with the condylar buttress plate with respect to infection, varus deformity, nonunion, and implant failure. Conclusion The distal femoral locked plate fixation provided better functional outcome and achieved better degree of knee flexion compared with the condylar buttress plate in the treatment of distal femoral fractures in the same fracture pattern.