A Prospective Study on Surgical Management of Closed Distal End Femoral Fracture in Adults Using Distal Femur Locking Compression Plate

Abstract

Background: Distal Femur fractures are a highly incident complex case and pose a challenge to the treating
orthopedician.
Aims and Objectives: The aims and objectives of this study were to assess radiological union of distal femoral
fractures by open reduction and internal fixation with locking compression plate, To study the functional
outcome for internal fixation of fractures of the distal end femur by Locking Compression Plate and To
evaluate the effectiveness and complications of distal end femur fractures treated with Locking Compression
Plate based on, time till union, rate of infection, and fixation failures, functional outcome using NEER’S SCORE.
Materials and Methods: The present study was done from April 2017 to April 2018 which comprised of
fifteen patients with closed Distal end Femoral Fractures who where treated by Locking Compression plate.
Overall final outcome was assessed in terms of radiological union, clinical assessment and regaining the lost
knee function using NEER’S Score.
Results: Out of 15 patients, 12 patients were males and 3 patients were females.Out of 15 patients, 14 were due to
RTA. Maximum number of cases was of Muller type C2-60%. Internal fixation was considered after patients
general and medical condition was stabilized. The average operative time was 90 minutes. The size of plate was
selected based on the type of fracture. 6 to 10 hole plate were used most commonly. Of 15 patients, 10(66.66%)
showed radiological union within 16 weeks. 9 (60%) of the patients achieved weight bearing at the end of 14
weeks. Average flexion in this study was 100 degree with more than 3 (20%) patients having knee range of
motion more than 110 degree. 1 Patient had stiff knee. More than 80% patients were extensor lag less than 5
degree. 2 patients had VARUS MALALIGNMENT out of 15 patients.Results according to NEER’S SCORE were
Excellent in 20% patients, Good in 60% , Satisfactory in 6.6% and unsatisfactory in 13.3% patients. 2 patients had
superficial infection and 1 patient had delayed union.
Conclusion: Locking compression plate is an optimal tool for Distal end femoral fractures. It provides rigid
fixation in the region of femur, where a wide canal, thin cortices and frequently poor bone stock make fixation
difficult.