Functional outcome of distal femoral fractures managed surgically using locking compression plate laterally and augmented with titanium elastic nail system medially

2021 ◽  
Vol 12 (3) ◽  
pp. 81-87
Author(s):  
Sujay K Mahadik ◽  
Sasha Martyres ◽  
Mrutyunjay S Gaonkar ◽  
Anish W Isapure ◽  
Shrikant B Deshpande
Keyword(s):  
Functional Outcome ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Full Weight Bearing ◽  
Titanium Elastic Nail ◽  
Femur Fractures ◽  
Compression Plate ◽  
Elastic Nail ◽  
The Mean

Background: Distal femur fractures are generally due to high velocity trauma particularly form road traffic accidents and fall from height. The treatment of distal femur fractures has evolved from conservative to operative to fixation of both lateral and medial columns of femur. Aims and Objective:  The aim of this study was to evaluate the functional outcome of operated cases of comminuted fracture of lower end of femur fixed with locking compression plate laterally and augmented with titanium elastic nail system medially. Materials and Methods: The present study was a prospective study carried out in Bharati Vidyapeeth Medical College and Hospital, Sangli after approval from institutional ethical committee. In this study, 20 patients with communited fracture of lower end of femur were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all cases. After preanesthetic evaluation and relevant investigations patients were treated by reduction (close or open) and fixation was done by locking compression plate laterally and augmented with titanium elastic nail system medially. Patients were followed up at 6, 10 and 14 weeks for functional outcome by Neer’s scoring system and degree of flexion at knee joint. Results: Out of 20 studied cases there were 16 (80%) males and 4 (20%) were females with a M:F ratio of 4:1. The mean age of male patients was found to be 42.81+/-14.79 whereas mean age of female patients was 40.5 +/- 14.36. The mean age of male and female patients was found to be comparable with no statistically significant difference (P=0.78). Most of the patient were diagnosed with the fracture of AO TYPE C3 (7 cases), followed by AO TYPE C1 (4 cases). Full weight bearing was achieved in 8 (40%) patients within 18 weeks whereas remaining 12 (60%) patients required more than 20 weeks for full weight bearing. 14 (70%) patients had excellent outcome whereas, Good, Fair and poor outcomes were seen in 4 (20%), 1 (5%) and 1 (5%) patient. On one-way ANOVA analysis, showed that the flexion was significantly higher in 12 weeks as that of the 6 weeks (P =<0.0001). Further the flexion was significantly higher in 24 weeks as that of the 6 and 12 weeks (P =<0.0001). Conclusion: Our study found that locking compression plating laterally augmented with titanium elastic nail system medially for comminuted distal femoral fractures is a good fixation system and provides good angular stability.

scholarly journals Radiologic and functional outcome in patients with ipsilateral fractures of proximal femur and shaft treated by long proximal femoral nailing

2020 ◽  
Vol 7 (1) ◽  
pp. 129
Author(s):  
Saju S. ◽  
Thomas M. A.
Keyword(s):  
Functional Outcome ◽  
Proximal Femur ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
The Mean ◽  
Mean Time ◽  
Proximal Femoral Nailing

<p class="abstract"><strong>Background:</strong> Combination of ipsilateral proximal femur and shaft of femur fractures are one of the rare fractures which were previously managed with two different implants for each fracture. Various studies have shown that long proximal femoral nailing is as effective as two different implants in fracture healing.</p><p class="abstract"><strong>Methods:</strong> 25 cases in the age group of 20-80 years with ipsilateral proximal femur and shaft of femur fractures were enrolled from July 2014 to July 2017 and treated with long proximal femoral nailing. The cases were followed up at 6 weekly intervals and were assessed for their functional outcome using Friedman and Wyman criteria.</p><p class="abstract"><strong>Results: </strong>Proximal femoral fractures united at an average time of 3.96 ±1.3 months, whereas the mean time shaft of femur fractures took to unite was 5.67±3 months. The mean time patients took to start full weight bearing was 6.15±2.76 months. Functional assessment at 12 months revealed outcome as good in18 (75%), fair in 5 (20.8%) and poor in 1 (4.1%).</p><p class="abstract"><strong>Conclusions:</strong> Long proximal femoral nailing is a good option in managing patients with ipsilateral proximal and shaft of femur fractures.</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 Surgical management of pertrochanteric fractures with proximal lateral femur locking compression plate

2016 ◽  
Vol 2 (4) ◽  
pp. 234
Author(s):  
Biju R. ◽  
Kumar Babu B.L.S. ◽  
Sarat Chandra M.
Keyword(s):  
Proximal Femur ◽  
Weight Bearing ◽  
High Stress ◽  
Locking Compression Plate ◽  
Full Weight Bearing ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Compression Plate ◽  
Type 3

<p><strong>Background:</strong> Pertrochanteric femoral fractures are of intense interest globally. Pertrochanteric fracture is a one of the most serious cause of mortality and morbidity in elderly people. The number of such admissions is on a raise because of increasing life span, sedentary habits and increased road traffic accidents. Pertrochanteric region is a high stress area. Hence delayed union, implant failures, varus collapse and non-union are common complications. Choice of implant was also a tough decision for surgeons in this area. Hence this study was intended to evaluate the functional outcome of proximal femur fractures treated with proximal femur locking compression plate (PFLCP) in terms of union of fracture, patient compliance and complications.</p><p><strong>Methods:</strong> This prospective study was conducted at the department of orthopaedics, Narayana Medical College and Hospital, Nellore from December 2014 to June 2016. The complete data was collected from all the patients by taking history of illness and by doing detailed clinical examination and relevant investigations. Finally after the diagnosis, the patients were selected for the study depending on the inclusion and exclusion criteria. Postoperatively all the cases were followed for the minimum period of 6 months to maximum period of 1 year.</p><p><strong>Results: </strong>In this study 22 patients were involved. There were 14 males and 8 females, with a mean age of 46 years. 19 cases were admitted due to slip and fall and with slight predominance of right side. Mean duration of hospital stay was 20 days and mean time of full weight bearing is 10 weeks. Out of 22 cases 2 cases lost follow up before first follow up time of 6 weeks. Out of 20, remaining cases 8 were type 3 and 12 were type 4. Functional results were graded by Harris hip scoring system. Good to excellent results were seen in 87% cases of type 3 fractures and 83% cases in type 4 fractures.</p><strong>Conclusions: </strong>Treatment with a PFLCP can provide good-to-excellent healing for proximal femur fractures, with a limited occurrence of complications especially for severe comminuted fracture and osteoporosis.

scholarly journals CASE SERIES -A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF SUBTROCHANTERIC FEMORAL FRACTURES TREATED WITH PROXIMAL FEMORAL LOCKING COMPRESSION PLATE

2020 ◽  
pp. 1-3
Author(s):  
Ajay Krishna ◽  
Thiagrajan Pandian
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Femoral Fractures ◽  
Good Method ◽  
The Elderly ◽  
Subtrochanteric Fracture ◽  
Locking Compression Plate ◽  
Bone Apposition ◽  
Femur Fractures ◽  
Compression Plate

Background and objective: Subtrochanteric fracture of femur and its complications account for significant morbidity and mortality especially in elderly.Proximal femoral locking compression plate helps in early Range of movements of the patient. Materials and Methods This study was done in SREE BALAJI MEDICAL COLLEGE AND HOSPITAL, CHROMEPETfrom August 2018 to May 2020.During this period 25 cases of adult patients with subtrochanteric fractures were treated with proximal femoral locking compression plate(PFLC). The classification used here was according to Seinsheimers and functional outcome was assessed using Traumatic hip rating score. Results: In our study of 25 patients 65% of them(16 patients) showed excellent results,30%(8 patients) showed good results,5%(1 patient)showed poor result due to Infection. Conclusion: Proximal femoral LCP is a good method for Subtrochanteric femur fractures in the elderly patients especially for severely communited fracture and with osteoporosis. Proximal femoral LCP gives the advantage of flexibility to surgeon to achieve angular stability or axial compression with plate to bone apposition.

scholarly journals Internal fixation of pediatric shaft femur fractures by titanium elastic nails: clinical and radiological study

2016 ◽  
Vol 2 (4) ◽  
pp. 299
Author(s):  
Manoharan M. ◽  
Mahapatra S.
Keyword(s):  
Weight Bearing ◽  
Joint Stiffness ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Age Group ◽  
Femur Fractures ◽  
Pediatric Age Group ◽  
Elastic Nails ◽  
Elastic Nail ◽  
Operative Fixation

<p class="abstract"><strong>Background:</strong> Management of diaphyseal femoral fractures in the pediatric age group is challenging. There has been a demand worldwide for operative fixation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Twelve children (7 boys, five girls) aged 6-16 years with diaphyseal femoral fractures (12 fractures, one in each) was stabilized with titanium elastic nail system (TENS). Patients underwent surgery within a week days of their injury. The results were evaluated using Flynn's Scoring system. Identical two nails were used in each fracture.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 12 patients were available for evaluation and follow-up for a mean duration of 24 months (14-34 months). Radiological union in all cases was seen at a mean duration of 8 weeks. Full weight bearing was possible at a mean duration of 10 weeks (8-12 weeks). The results were excellent in 8 patients (67%) and satisfactory in 4 patients (33%).  Complications that occurred were infection (2 cases), knee joint stiffness (4 cases), angulation &lt;10 degrees (1 case), and shortening less than 10 mm (2 cases)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Intramedullary fixation by TENS is an effective, time-tested treatment of fracture of the femur in patients of the 6-16 years age group<span lang="EN-IN">.</span></p>

scholarly journals Management of distal femur fractures with locking compression plate: a prospective study

2018 ◽  
Vol 4 (2) ◽  
pp. 208
Author(s):  
Sridhar Reddy Konuganti ◽  
Sreenath Rao Jakinapally ◽  
Vennamaneni Pratish Rao ◽  
Sivaprasad Rapur
Keyword(s):  
Prospective Study ◽  
Distal Femur ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Functional Score ◽  
Non Union ◽  
Distal Femoral Fractures ◽  
Femur Fractures ◽  
Compression Plate ◽  
The Mean

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Distal femur fractures need to be treated operatively to achieve optimal outcomes. Different types of internal fixation devices have been used but, the number of revisions for non-union, loss of reduction and implant failure has been high.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective study reviewed 20 cases of distal femoral fractures surgically managed with distal femoral locking compression plate between December 2013 and December 2015 at Mediciti Institute of medical sciences, Ghanpur, Medchal, tertiary care referral and trauma centre. Fractures were categorized according to OTA classification by Muller</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Highest number of patients was in their 3rd decade (25%) 18 out of 20 patients had closed injury. Type A2 Muller’s fracture was the most common fracture type 7 out of 20 patients (35%).The mean follow up period in this study was 8 months. The average range of knee flexion achieved was about 109°. The mean score 81.75 points were rated using Neer’s functional score (Max 100). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The locking compression plate is the treatment of choice in the management of comminuted distal femoral fractures especially Type A fractures where we have found higher Neer scores. It may not completely solve the age-old problems associated with any fracture like non-union and malunion, but is valuable in the management of these fractures.</span></p><p class="Default"> </p>

scholarly journals Comparison of study of a dynamic condylar screw surgery and distal femoral locking compression plate technique in distal femoral fractures

2017 ◽  
Vol 3 (3) ◽  
pp. 440
Author(s):  
G. Ramachandra Reddy ◽  
P. N. Prasad
Keyword(s):  
Locking Plate ◽  
Weight Bearing ◽  
Locking Compression Plate ◽  
Full Weight Bearing ◽  
Average Hospital ◽  
Plate Technique ◽  
Dynamic Condylar Screw ◽  
Fracture Management ◽  
Compression Plate ◽  
The Mean

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">An extensive soft tissue damage, intra articular extension, severe comminution and injury to the quadriceps mechanism make the management of the distal fractures of the femur a significant challenge. The advent of techniques such as dynamic condylar screw surgery and distal femoral locking compression plate technique have improved the, management of these fractures compared to the conventional methods. We in the present study have attempted to compare the outcomes of Dynamic condylar screw surgery and distal femoral locking compression plate technique.</span></p><p class="abstract"><strong>Methods:</strong> 72 patients over the age of 20 years who sustained simple or compound factures of the lower 1/3rd of femur and admitted into our hospital were included into the study. The patients were divided into 2 groups, one group who underwent Dynamic condylar screw surgery and the other groups were managed by distal femoral locking compression plate technique.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The most common cause of fracture was road traffic accidents, involving both two wheelers as well as four wheelers (51.4%). 19.4% of the patients had a fall from height and 13.9% had a fall from standing height. The mean operative time in DCS was about 121 minutes in comparison to 118 minutes in the LCP. The average hospital stay and the no of RBCs used were comparable in both the cases. Although the mean number of days for full weight bearing as well as the average time of union of the fracture was marginally lower in LCP than in DCS, it was not significant. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">It is therefore observed that both condylar screw and the locking plate are very similar in their performance and satisfaction to the patients, although distal femoral locking plate is better in comminuted distal fracture compared to the dynamic condylar screw fracture management.</span></p>

scholarly journals Outcomes of Surgical Management of Distal Femur Fracture with Distal Femoral Locking Compression Plate at Koshi Zonal Hospital

2018 ◽  
Vol 2 (3) ◽  
pp. 260-265
Author(s):  
Shambhu Sah ◽  
Navin Kumar Karn ◽  
Bikash KC ◽  
Roshan Yadav ◽  
Sailj Jung Dangi ◽  
...  
Keyword(s):  
Distal Femur ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Locking Compression Plate ◽  
Fixation Method ◽  
Full Weight Bearing ◽  
Femur Fractures ◽  
Duration Of Surgery ◽  
Compression Plate

Introduction: Distal femoral fractures comprise 4-6% of all femur fractures. The management of distal femur fractures are challenging because of significant morbidity and complication rate even with advanced surgical techniques and implants. Open reduction and internal fixation (ORIF) with pre-contoured distal femoral locking compression plate (DF-LCP) is one of the most acceptable surgical procedures these days.Objectiv: Evaluation of functional outcomes of distal femur fractures managed surgically using DF-LCP at Koshi Zonal Hospital.Methodology: In this cross sectional study 21 patients having closed distal femur fractures with or without intra-articular extension to femoral condyle fixed with DF-LCP at Koshi Zonal Hospital, Nepal from March 2016 to March 2017 were included. Patients with open fracture, severe comminuted fracture, and neurovascular impairment were excluded. These patients were followed-up for up to one year and we recorded the knee range of motion, full weight bearing time fracture union time, and complications. We used Neers' functional scoring system to evaluate the final outcomes and data was analysed using Microsoft Excel Programe.Results: Out of the 21 patients of distal femur fractures, 16 were diametaphyseal distal femur fractures and five were supracondylar fractures with intra-articular extension. Mean age recorded was 45 (range 19-75) years, hospital stay mean duration 12 (range 10-19) days and duration of surgery 85 (range 60-150) minutes, full weight bearing walking time mean 16 (range 12-22) weeks, radiological union time mean 20 (range 17-29) weeks and Neers' score was excellent in 66.66%, satisfactory in 23.80%, unsatisfactory in 4.76%, and poor in 4.76%.None of our patients had complications like; loss of fixation, implant failure or post-operative neurovascular injury.Conclusion: Distal Femoral Locking Plate is one of the best implant to be used as fixation method for both extra-articular and intraarticular distal femur fracture.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 260-265  

scholarly journals A study on the outcome of displaced midshaft non-comminuted clavicle fractures treated with anatomical locking plate versus titanium elastic nail

2020 ◽  
pp. 221049172097518
Author(s):  
Vineet Thomas Abraham ◽  
Chandrasekaran Marimuthu
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Plate Versus ◽  
Dash Score ◽  
Titanium Elastic Nail ◽  
Constant Murley Score ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Quick Dash

Purpose: Fixation of displaced midshaft clavicle is well known to decrease nonunion, malunion and shoulder disability as compared to nonoperative treatment. This study was done to compare the clinical and functional outcome of group 1 clavicle fractures treated with anatomic locking plates (ALP) versus Titanium elastic nail (TEN). Methods: We studied patients presenting with displaced midshaft clavicle fractures treated with ALP or TEN. The study period was from Jan 2013 to Dec 2016. Patients were reviewed and at each visit clinical and radiological progress of union was noted, complications if any were noted, functional assessment was done using the quick Dash score and Constant Murley score. Results: A total of 116 patients met our inclusion criteria. 62 patients were treated with TEN and 54 with ALP. Bony union was achieved at an average of 11.8 weeks in the TENS group and 12.8 weeks in the ALP group post operatively and this was found to be significant. The mean postoperative Constant Murley score in the ALP and the TEN groups were 92.8 (range 80–97), and 93.7 (82–97) respectively. The mean postoperative quick dash score in the ALP and TEN groups were 2.48(range from 0 to 6.8) and 2.1 (range 0–9.1) respectively. Conclusion: Both Anatomical locking plate and TEN are good options for the treatment of non-comminuted mid clavicular fractures as they have a similar functional outcome. TEN nail insertion has the advantage of being minimally invasive, having a faster union time and may be recommended in midshaft clavicle fractures without comminution.

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

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