A clinical study of surgical management of distal femur fracture using locking compression plate

Background: Fractures of distal femur are common due to increased road traffic accidents and fall from height because of increased construction activities. These fractures are quite disabling hence, these fractures necessitate early stabilization of fractures. Internal fixation with LCP has shown to give one of the best results in terms of recovery, fracture union, and clinical outcome. The aim of the study the clinical outcome of treatment of distal femur fractures using locking compression plates.Methods: A total of n=20 cases of distal femur fractures treated with LCP from December 2013 to June 2015 at NMCH and RC, Raichur. They were admitted and examined according to protocol clinically and radiologically. All patients were followed up for a minimum of 6 months and outcome assessed with Neer’s score.Results: All fractures healed with an average duration of 16 weeks which is comparable with other studies. We had two cases of varus collapse one was due to early weight bearing in one case and other case is due to gross communition. One case had an implant failure (plate breakage) due to early weight bearing. Cases needing hardware revision is comparable to other studies at 10%. Average Neer's knee score was 76.Conclusions: we have found higher Neer’s scores in this study. The LCP also prevents compression of periosteal vessels. It may not completely solve the age-old problems associated with any fracture like non-union and malunion, but is a valuable technique in the management of these fractures. But however, in type C fractures the outcome is poorer.

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Evaluation of functional outcome of treatment for distal femur fractures

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2597 ◽

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.

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Locking condylar plate: best device to treat supracondylar fractures of the femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190966 ◽

2019 ◽

Vol 5 (3) ◽

pp. 393

Author(s):

Irwant V. Pallewad ◽

Vijay B. Kagne ◽

Jayshree J. Upadhye

Keyword(s):

Fracture Fixation ◽

Distal Femur ◽

Road Traffic ◽

Weight Bearing ◽

Femoral Fractures ◽

Research Centre ◽

Full Weight Bearing ◽

Supracondylar Fractures ◽

Femur Fractures ◽

Fractures Of The Femur

Background: Supracondylar fractures of the femur in adults account for only 7% of all femoral fractures. However, these fractures present with numerous complications. The purpose of this study was to assess the outcome of locking condylar plate in supracondylar fractures of femur in adults.Methods: This study was based on 25 patients of supracondylar fracture of the femur treated with locking condylar plate at Srinivas Institute of Medical Sciences and Research Centre, Mukka, Suratkal, Mangalore. The patients were followed up for 1 year.Results: In present study, 84% fractures were sustained due to road traffic accidents. In 23 (92%) patients, full weight bearing was achieved at 20 weeks while only 2 (8%) patients required more than 20 weeks. 80% of cases required less than 16 weeks for union while 20% required more than 16 weeks. Average injury to surgery time was 3.62 days in the present series. Superficial stitch infection occurred in two cases. Deep infection occurred in a grade 2 compound fracture in a male who was treated initially with debridement and antibiotics.Conclusions: Good results are seen by distal femur locking condylar plate alone. It is the main implant of choice for distal femur fractures of all varieties. Best outcome is expected if fracture fixation is done following all the basic principles of fracture fixation. Advantage of the mechanical properties of a locking plate is definitely useful.

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Is locking compression plate the best modality of treatment for distal femur fractures?

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20184205 ◽

2018 ◽

Vol 4 (6) ◽

pp. 826

Author(s):

R. G. Koteeswar Rao ◽

Pratheesh Mohanraj ◽

Mohan Kumar M.

Keyword(s):

Traffic Accidents ◽

Distal Femur ◽

Road Traffic ◽

Age Distribution ◽

High Energy ◽

Locking Compression Plate ◽

Time Interval ◽

Excellent Outcome ◽

Femur Fractures ◽

Compression Plate

Background: This observational study was conducted in order to study the functional efficacy of locking compression plate in distal femur fractures as they are one of the most common type of fractures with bimodal age distribution affecting younger age group as a consequence of high energy trauma especially road traffic accidents and elderly population due to osteoporosis.Methods: 40 Patients who are skeletally matured with acute distal femur fractures were radiologically assessed type of fractures, amount of comminution, articular congruence and quality of bone. pretested proforma which include age, sex, occupation, mode of injury, type of fracture, time interval between injury and surgery, associated comorbid conditions and other associated injuries.Results: Off the 40 patients under study 21 showed excellent outcome according to neers rating system and only 5 had fair results, 3 patients had superficial wound infection and 5 developed knee stiffness.Conclusions: Locking compression plate produces better results and appears to be good method of management in distal femur fractures.

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Distal femur fractures: weight bearing and alternative constructs

OrthoMedia ◽

10.1302/3114-210157 ◽

2021 ◽

Keyword(s):

Distal Femur ◽

Weight Bearing ◽

Femur Fractures

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SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.876 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Mahesh Kumar Sharma ◽

Dr. Arun Bhargava

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Traffic Accident ◽

Traffic Accidents ◽

Splenic Injury ◽

Road Traffic ◽

Age Groups ◽

Operative Management ◽

Fall From Height ◽

Type Of Injury

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. So we evaluate the spectrum and outcome of blunt trauma. Methods: Hospital based prospective study conducted on 100 patients at department of general surgery. Results: Distribution according to type of injury consisted of maximum cases, 84 (84%) of road traffic accidents, 11% cases were of fall from height. Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment. Keywords: Blunt abdominal trauma, Liver injury, Perforation, Splenic injury

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Surgical Treatment of Distal Femur Fractures using LISS System

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200310336-42 ◽

2003 ◽

Vol 10 (3) ◽

pp. 36-42

Author(s):

D Cherkes-Zade ◽

M Monesi ◽

A Causero ◽

M Marcolini ◽

D Cherkes-Zade ◽

...

Keyword(s):

New Technology ◽

Weight Bearing ◽

Long Bone ◽

Operative Trauma ◽

Early Weight Bearing ◽

Femur Fractures ◽

Bone Fragments ◽

Total Knee ◽

Using Data

Osteosynthesis with LISS system (less invasive stabilization system) is a new technology and this conception of stabilization of long bone fragments is a new step in the development of AO philosophy. Indications to application of this system are distal metaepiphysis and diaphysis femur fractures, supra- and transcondylar fractures in polytrauma, fractures in osteoporosis as well as fractures after total knee replacement. During the last 3 years 35 patients were operated on by that technique. The follow-up period ranged from 6 months to 3 years. Assessment of outcomes was performed using data of clinical examination and evaluation of radiograms with modified Neer-Grantham-Shelton scale. In patients who were operated on I year ago the total score varied from 70 to 80 (maximum - 100). Advantages of this technology as compared to the traditional methods of osteosynthesis are the following: limited operative trauma, less blood loss, shortening of surgery duration, preservation of tissue physiology as well as absence of the necessity to use cement and bone auto- and allografts. Disadvantages include the difficulty for reposition prior to fixation and impossibility of correction in postoperative period as well as early weight-bearing load.

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Comparison of Titanium Elastic Nailing and End-threaded Intramedullary Pinning for Distal Femoral Fractures in Young Dogs

Indian Journal of Animal Research ◽

10.18805/ijar.b-4454 ◽

2021 ◽

Author(s):

Harmanpreet Singh Sodhi ◽

Ashwani Kumar ◽

Arun Anand ◽

Vandana Sangwan ◽

Opinder Singh

Keyword(s):

Stainless Steel ◽

Functional Outcome ◽

Weight Bearing ◽

Femoral Fractures ◽

Titanium Implants ◽

Early Weight Bearing ◽

Femur Fractures ◽

Elastic Nails ◽

Group 2 ◽

Group 1

Background: Femur fractures are common in immature dogs. As compared to stainless steel, titanium implants are lighter and allow controlled micro-motion at the site of fracture that stimulates early callus formation by limiting stress shielding. Cited literature reports successful clinical use of titanium elastic nails for the stabilization of long bone fractures in young human patients; however, there is paucity of information on this technique is dogs. This study was planned with an objective to compare titanium elastic nails (TENS) and single end-threaded pin for the management of femoral fractures in young dogs. Methods: The study included 20 clinical cases (10 male and 10 female) of dogs suffering from distal femoral fracture with a mean ± SD age of 5.70 ± 5.60 month, body weight 11.09 ± 4.48 Kg since 3.05 ± 2.35 days. The cases were divided into 2 groups; using TENS (n=10; group 1) and stainless steel end-threaded intramedullary pin (n=10; group 2). Result: Group 1 dogs demonstrated better fracture reduction score, early and uniform callus and better implant stability as compared to group 2, radiographically. Early weight bearing and minimum postoperative complications with better functional outcome including joint mobility was reported in group 1. In conclusions, TENS is superior fracture fixation technique for the repair of supracondylar or distal third femur fractures in young dogs with better functional outcome, minimal stiffness of stifle joint and early weight bearing, in comparison to single end threaded intramedullary pin.

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Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171891 ◽

2017 ◽

Vol 3 (3) ◽

pp. 497

Author(s):

Vijaysing S. Chandele ◽

Abhishek P. Bhalotia ◽

Milind V. Ingle ◽

Maroti R. Koichade

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Weight Bearing ◽

Oxford Knee Score ◽

Tibial Plateau Fractures ◽

Knee Score ◽

Early Weight Bearing ◽

Non Union ◽

Approach Time

Background: Management of tibial plateau fractures with coronal fractures especially posteromedial fragment is frequent and challenging. This study was conducted to evaluate the functional outcome of patients with tibial plateau fractures having posteromedial fragment treated with open reduction and internal fixation (ORIF) using Lobenhoffer approach.Methods: Thirty two patients with tibial plateau fractures having posteromedial fracture alone or part of bicondylar fracture was operated with ORIF using Lobenhoffer approach. Time to union, maintenance of alignment, rate of complications and functional outcome was assessed using Oxford knee score.Results: The mean time to healing was 16.4 weeks, without any complication in the form of non-union and infection. Malunion with secondary loss of alignment was seen in only one case due to fracture comminution and early weight bearing. Oxford knee score was good to excellent in all the cases. Conclusions: With recent development in understanding these fractures, ORIF gives excellent to good outcome in all patients operated through Lobenhoffer approach. Long term disability can be prevented by maintenance of adequate alignment and reduction through direct visualization of fracture.

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Profile of unnatural deaths in a teaching hospital of West Bengal, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20200950 ◽

2020 ◽

Vol 7 (3) ◽

pp. 971

Author(s):

Satabdi Mitra ◽

Saumabrata Panja

Keyword(s):

Traffic Accidents ◽

Burn Injury ◽

Road Traffic ◽

Care Facility ◽

Health Care Facility ◽

Binary Logistic Regression ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Fall From Height

Background: Enquiry into unnatural deaths with all its manners being, suicidal, accidental or homicidal depends on circumstantial evidences for acceptable judgment in court of law. Objectives were to study socio-demographic characteristics of the study and to find out influencing factors, if any, behind these sudden, suspicious, undesirable deaths.Methods: A record-based, descriptive study with cross-sectional design was conducted for first six months of 2017 in NRS medical college hospital among 1603 unnatural deaths undergone police inquest. Besides the records obtained from medical record section, findings were corroborated from mortuary. Data were analyzed in SPSS 22.0 and Epi Info 7.0.Results: Mean age of the deceased was 37.18±17.42 years. Regarding cause of injury, more than 1/3rd (36.6%) was attributed to poisoning, followed by burn injury (24.8%), road traffic accidents (22.8%), fall from height (6.9%) and others the rest. Majority (68.3%) died within twenty hours of reaching the health care facility. More than half of the deceased committed suicide followed by accident and suicide the least. Binary logistic regression revealed, unnatural deaths inflicted by selves or others, i.e. suicide or homicide respectively, had statistically significant (p<0.05) association to productive age, urban residence, burn and RTA, longer survival and conservative nature of management.Conclusions: As suicide was found to comprise lion share of unnatural deaths, development and implementation of addressing the issue at all the levels, starting from individual to community is the need of the hour.

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Study of surgical outcome of mid third clavicle fractures surgically managed by locking compression plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214965 ◽

2021 ◽

Vol 8 (1) ◽

pp. 72

Author(s):

Potharaju Swetha Rani ◽

M. Zeeshan Vasif

Keyword(s):

Functional Outcome ◽

Road Traffic ◽

Constant Score ◽

Clavicle Fracture ◽

High Energy ◽

Bony Union ◽

Non Union ◽

Fall From Height ◽

Clavicle Fractures ◽

A Prospective Study

Clavicle is one of the most frequently fractured bones in young and active individuals. They account for 2.6-12% of all fractures and for 44-66% of fractures around the shoulder. Majority of clavicle fractures are mid shaft (80-85%). Functional outcome of midshaft fracture not only depends on the union but also on its length which has to be maintained. Thus a displaced or comminuted fracture carries a risk of symptomatic malunion, non-union or poor functional outcome with cosmetic deformity. The recent trend is shifting to internal fixation of these displaced mid shaft clavicle fracture. This was a prospective study of 20 cases of fresh mid third clavicle fracture admitted to MNR medical college and hospital from August 2020 to September 2021. Cases were taken according to inclusion and exclusion criteria. Medically unsuitable and patients not willing for surgery were excluded from the study. There were 17 male patients and 3 female patients with mid 1/3 closed clavicle fracture. 12 patients had right sided clavicle fracture and 8 patients had fracture of the left clavicle. All 20 fractures were closed fractures. Majority of the patients sustained fracture due to road traffic accident (high energy trauma) in 16 cases, fall from height in 3 cases and assault in one case. The mean duration to surgery from the day of presentation and injury was 2.1 days for middle third clavicle fractures. Functional outcome as assessed by constant and Murley scoring was favourable with excellent to good result in 97% cases and fair in 3% cases. The average constant score was 93.35 in one year follow up in middle third group. This study has some limitations. The conclusions drawn from this analysis cannot be generalized because of the small number of cases. In conclusion, for middle third clavicle fractures bony union could be achieved with locking compression plates and the clinical outcomes were satisfactory. All the fractures united and there were no cases of nonunion.

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