scholarly journals Reconstruction of complex distal femur open fracture with distal femoral locking plate and primary autologous free fibular graft

2017 ◽  
Vol 3 (5) ◽  
pp. 1066
Author(s):  
Rajagopal H. P. ◽  
Madan Mohan M. ◽  
Anoop Pilar ◽  
Keith Behram Tamboowalla
Keyword(s):  
Functional Outcome ◽  
High Velocity ◽  
Open Fracture ◽  
Distal Femur ◽  
Locking Plate ◽  
Road Traffic ◽  
Fibular Graft ◽  
Wound Debridement ◽  
Femur Fractures ◽  
Koos Score

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Distal femur fractures are high velocity injuries which accounts for 7-10% of all femoral fractures. These injuries are complex injuries which are difficult to manage. Despite advances in techniques and implants, treatment remains a challenge, in many situations.</span></p><p class="abstract"><strong>Methods:</strong> We present a retrospective review of 8 cases, involved in high velocity road traffic accident who presented to emergency department at St. John’s Medical College, Bangalore, Karnataka, India between September 2011 to December 2015, with complex open fracture of the distal femur with bone loss. All were managed with initial wound debridement and skeletal traction. Subsequently fractured femur was reconstructed with distal femoral locking plate stabilization, along with autogenous non vascularised fibular graft and cortical-cancellous graft bridging the bone defect. Radiological union, functional outcome measured with Tegner and Lyslom scores, KOOS score and complications were assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">At average 5 years follow up, all the fractures have united well, with good functional outcome. X-ray showing united fracture with incorporation of the fibular graft. According to Tegner and Lyslom scoring, 6 patients had good rating, 2 had satisfactory rating. Average KOOS score was 82.15. Shortening of 2 cm and 4 cm in couple of patients was the major complication. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Delayed primary surgery, using autologous non vascularised free fibular graft in conjunction with a locking compression plate, with autogenous cortico-cancellous graft is an effective, less technically demanding and cost effective means of reconstruction option to manage bone defects in complex open fractures of the distal femur. An overall acceptable results in terms of fracture union, fibular incorporation, adequate restoration of knee motion and early rehabilitation can be expected.</span></p>

scholarly journals A clinical study in distal femur fractures management with locking compression plate without C-arm images

2019 ◽  
Vol 5 (5) ◽  
pp. 875
Author(s):  
Gaurav Singla
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Locking Plate ◽  
Imaging Modality ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Anatomical Location ◽  
Anatomical Reduction ◽  
Femur Fractures ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Distal femur fractures pose a surgical challenge to the orthopaedic surgeons. Multiple implants are available but locking compression plate is a good implant to be used in this anatomical location. LCP may reduce the tendency of varus collapse and offers higher stability than other implants. Aim of our study was to review functional outcome, union time and complications in distal femoral fractures treated with distal femoral locking plate without C-arm imaging modality.</p><p class="abstract"><strong>Methods:</strong> 25 patients with closed or open type grade1 and 2 distal femur fractures managed with open method locking compression plate without C-arm image. Pritchett rating system was used for evaluation of outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients in this series united well with an average time of 13 weeks with minimal complications. Functional outcome was excellent in 4 patients, good in 19 patients, fair in 2 patients.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and locking compression plate is suitable implant available for fixation of distal femur fractures with minimal complications. Even it can be done without C-arm. Surgical technique and proper anatomical reduction and alignment are the key for good results.</p>

scholarly journals A prospective study of functional outcome of distal femur fractures by locking plate

2020 ◽  
Vol 6 (1) ◽  
pp. 359-363
Author(s):  
Dr. Abhishek Shenoy ◽  
Dr. Anil Bulagond ◽  
Dr. OB Pattanashetty ◽  
Dr. Dayanand BB
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Distal Femur ◽  
Locking Plate ◽  
Femur Fractures ◽  
A Prospective Study

scholarly journals Evaluation of functional outcome of treatment for distal femur fractures

2020 ◽  
Vol 11 (3) ◽  
pp. 4006-4015
Author(s):  
Vilas S. Mane
Keyword(s):  
Functional Outcome ◽  
Traffic Accidents ◽  
Distal Femur ◽  
Road Traffic ◽  
Excellent Result ◽  
Operative Procedure ◽  
Advantages And Disadvantages ◽  
Femur Fractures ◽  
High Speeds ◽  
Articular Fractures

In the past few decades man has taken traveling to high speeds with flexed knee joint with much of impacts taken first by patella then femoral condyles and tibial condyles in different positions and proportions and with vast increment in technology, travel modalities and industrialization there have been advantages and disadvantages too like easier and faster traveling but road traffic accidents too. Such accidents and falls resulting in loss of lives and disabilities. In recent years with the advancement of technology and facilities, wide use and trend of open reduction & internal fixation has been apparent. This study evaluated the functional outcome of treatment for distal femur fractures. Patients were operated from 5 days to 35 days. Mean injury to surgery duration was 13.24 days patients were operated between 80 min to 160 min with mean time for operative procedure was 112.4 minutes, Open fractures were seen in 14(56%) closed fractures were seen in 11(44%). There were 14(56%) intra articular fractures and 11(44%) extra articular fractures. Comminution was present in 16(64%) fracture patterns in our study. All patients were operated with distal femur condylar locking compression plate. AO type C 3 fractures 7(28%) were most common type of fractures. Knee mobilization was started as early as within 2 weeks. Average time was 7.68 weeks. Functional outcome was analyzed according to the NEERS knee scoring system, 10(40%) observed excellent result, 5(20%) observed good results, 7(28%) observed fair result and 3(12%) observed poor results.

A COMPARATIVE STUDY TO DETERMINE THE KNEE JOINT FUNCTIONAL OUTCOME IN PATIENTS WITH FEMUR SHAFT FRACTURES MANAGED OPERATIVELY OR CONSEVATELY AT NDOLA HOSPITAL:complete enumeration (Preprint)

2019 ◽  
Author(s):  
Ripedah Nakana
Keyword(s):  
Knee Joint ◽  
Functional Outcome ◽  
Road Traffic ◽  
Femur Fracture ◽  
Conservative Group ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Femur Shaft ◽  
Femur Shaft Fractures

BACKGROUND According to WHO, It has been reported that there has been a rise in road traffic accidents globally due to many factors. Consequently this has contributed to an increase in fracture of the femur in hospitals. The annual incidence of these Fractures has been estimated to be 10 per 100,000 persons and this incidence has been noticed to be higher among the youths decreasing after the age of 40 and then increasing in the elderly. These fractures are either managed conservatively or operatively. OBJECTIVE the aim of this study was to determine if there is a significant difference in knee joint functional outcome in patients with femur shaft fractures managed operatively and conservatively at Ndola Teaching Hospital at the orthopedics clinic and physiotherapy. This in future might help to place emphasis on government to sensitize the right measures needed to improve on the functional outcome of a knee joint in patients with femur fracture who are treated operatively or conservatively METHODS the method used for the study was a complete enumeration of all patients with femur fractures that were admitted at orthopedic ward, visited the orthopedic clinic and physiotherapy sessions at NTH between the period of July 2019 to September 2019. Data collected will be analyzed using a statistical data software called Statistical Package of Social Sciences (SPSS). The independent variable that will be considered in the study are age, DOI, DOA, femur shaft fractures, treatment and others that that will meet the selection Criteria. The dependent variable will be “Knee Joint Functional Outcome”. RESULTS Results did not show statistically significant difference in knee functional outcome for two methods (conservative or operative). In the current study it was noted that there was much reduction in swelling in the operative in comparison to the conservative group. We may therefore conclude that the operative management promises a better outcome especially when done on time. However it seemed the operative procedure was not preferred for any conservative approach however the study has shown an in depth feasibility study to affirm such findings in order to inform on policy or management paradigim shift. CONCLUSIONS There is need for further intervention in the management of femur fracture which complicates to poor knee joint function

scholarly journals Results of distal femur locking plate in communited distal femur fractures

2018 ◽  
Vol 4 (2d) ◽  
pp. 231-235
Author(s):  
Dr. Hemeshwar Harshwardhan ◽  
Dr. Arun Kumar Rajpurohit
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Femur Fractures

scholarly journals Evaluation of functional outcome following ORIF with Distal femoral locking plate in Intraarticular fractures of the distal femur

2021 ◽  
Vol 12 (1) ◽  
pp. 228-233
Author(s):  
Yeshwanth subash ◽  
Damodharan ◽  
Vishnu
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Locking Plate ◽  
Functional Evaluation ◽  
Union Rate ◽  
Fracture Union ◽  
Biological Fixation ◽  
Intraarticular Fractures ◽  
Excellent Functional Outcome ◽  
The Right

Fractures of the distal femur are high-velocity injuries and are associated with factors such as fracture comminution and osteoporosis, especially in elderly individuals which are quite challenging to manage. Various implants and techniques are available for the surgical management of these fractures. This study was performed to evaluate the functional outcome of these fractures following ORIF (Open reduction and internal fixation) with the DFLP (Distal femoral locking plate). Thirty patients with distal femoral intraarticular fractures who presented between February 2013 to February 2016 were managed by ORIF with DFLP and were followed up for three years. Functional evaluation was performed using the Neers scoring system. The average age of the patients was 38.06 years ranging from 22 to 64 years. There were twenty-one males, and nine females seen in our study with the right side being more commonly affected. We achieved a 100% union rate in our series with the meantime to fracture union being 12.86 weeks. We had excellent results in 65% of patients and satisfactory results in 35% of patients with minimal complications. ORIF with the DFLP is a unique biological fixation option in intraarticular fractures of the distal femur, and it provides for reasonable rates of fracture union and an excellent functional outcome with minimal complications.

scholarly journals Assessment of efficacy of locking compression plate in distal femur fractures

2021 ◽  
Author(s):  
Faizal Ali A. A. ◽  
Govind Karunakaran ◽  
Hijas Hameed
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Oxford Knee Score ◽  
Locking Compression Plate ◽  
Knee Score ◽  
Medial Condyle ◽  
Excellent Outcome ◽  
Femur Fractures ◽  
Articular Fractures ◽  
Compression Plate

Background: Distal femur fractures account for an estimated 6% of all femur fractures. Our study aims at evaluating the functional and radiological outcome in distal femur fractures treated with locking compression plate (DF-LCP).Methods: Patients undergoing LCP were assessed postoperatively both functionally and radiologically. Oxford Knee Score was used to assess the functional outcome. With a maximum score of 48, a score of more than 41 is scaled as excellent, 34 to 40 as good functional status, 27 to 33 as fair and score less than 27 as poor functional result.Results: Extra-articular fractures were the commonest (66.7%) type of fractures [simple-6.7%; metaphyseal wedge-20%; metaphyseal complex-40%] followed by complete articular fractures (26.7%) [Simple articular metaphyseal comminution-16.7%; metaphyseal and intra-articular comminution-10%] and partial articular fractures (6.7%) [Medial condyle-3.3%; coronal plane-3.3%]. Most of them had right sided femur injury (66.7%) and had history of fall (70%). Radiologically, 90% exhibited no complications and had united appropriately. Functionally the mean oxford knee score was 41.53±1.69 which ranged from a score of 38 to a maximum of 44. Highest proportion i.e., 63.3% had excellent outcome followed by good functional outcome and none showed fair or poor outcomes.Conclusions: LCP has shown very good radiological and functional outcomes with hundred percent union of the distal femur fractures. Hence it can be used successfully in distal femur fractures.

scholarly journals RETROGRADE INTRAMEDULLARY SUPRACONDYLAR NAILING AND DISTAL FEMORAL LOCKING COMPRESSION PLATE IN THE MANAGEMENT OF DISTAL FEMUR FRACTURES – A COMPARATIVE STUDY

2021 ◽  
pp. 97-99
Author(s):  
NARSIMHULU SY ◽  
HARI KUMAR S
Keyword(s):  
Blood Loss ◽  
Distal Femur ◽  
Road Traffic ◽  
Damage Control ◽  
Plate Fixation ◽  
Locking Compression Plate ◽  
Supracondylar Fractures ◽  
Fracture Union ◽  
Femur Fractures ◽  
Compression Plate

Objectives: The objective of the study is to assess the efficacy of retrograde intramedullary interlocking supracondylar nailing and distal femoral locking compression plate in the management of distal femur fractures. Methods: The present prospective study consists of a total of 36 cases with extra-articular supracondylar fractures of the femur between the age group of 21–70 years. Participants were randomly allocated to group 1 treated with distal femoral locking compression plate fixation and group 2 treated with retrograde intramedullary interlocking supracondylar nailing technique. Post-operatively, all the cases were followed up in regular intervals to assess the functional outcome using the American Knee Society score. Results: Road traffic accidents (80.56%) were the most common cause of injury. The average surgical duration (108 min and 90.14 min), duration of fracture union (12.48 weeks and 11.08 weeks), and blood loss (339.8 ml and 236.6 ml) was better in the nailing group than the plating group, respectively. The overall outcome was comparable between the two study groups. Conclusion: The supracondylar nailing technique has better functional outcomes in terms of less fracture union time, less operative duration, and minimal operative blood loss. Supracondylar nailing technique was effective and better in soft tissue damage control.

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