Treatment of distal end of fracture femur by locking compression plate

Abstract

Background: Treatment of distal femur fracture is challenge and usually requires to be treated surgically. Complexity of fractures needs the treatment to be changed from simple extraarticular supracondylar types to intercondylar and metaphyseal comminuted types. The locking compression plate (LCP) possesses exclusive biomechanical function that depends on splinting and not on compression, leading to flexible stabilization, quick healing, and decreased bone resorption as blood supply is conserved. Objective: To evaluate the functional outcome and complications of distal end femur fractures treated with LCP based on rate of union, time till union, rate of infection, varus and valgus malalignment, and fixation failures. Materials and Methods: A prospective study carried out over 1 year and enrolled totally 20 cases of fracture of lower end of the femur. Fractures were classified with the help of radiographs according to the AO-ASIF classification. Reduction of the condyles and fixation were done, and titanium plate was implanted with locking compression screws. Patients were followed up for 9 months and assessed clinically, radiologically, and functionally for functional outcome, fracture healing, and the complications of fracture and surgery. Result: The most common age group was 51–60 years (6), with male (16) predominance. The most common type of fracture according to Muller’s classification was Muller’s type C1 (30%). All patients underwent surgery within 7 days of injury; 85% patients showed radiological union within 18 weeks, and 70% patients achieved weight bearing within 14 weeks. Thirteen (65%) patients achieved knee flexion more than 110° and 5 (25%) patients achieved flexion between 90° and 110°. Two patients revealed shortening of 15 mm and one patient showed shortening of 10 mm; 55% (11) achieved excellent while 25% (5) had achieved good functional results according to Neer score. Conclusion: LCP is a significant armamentarium used in the therapy of fractures of distal end femur. However, careful understanding of its basic principles and identification of appropriate fracture pattern for use of LCP are essential to avoid complications such as generation of infections and non- and delayed unions.