RADIOLOGICAL AND FUNCTIONAL OUTCOME OF DUAL PLATING IN DISTAL FEMUR MULTIFRAGMENTARY ARTICULAR FRACTURES: A SHORT TERM STUDY

2021 ◽  
pp. 31-35
Author(s):  
V J Purushotham ◽  
Abhishek Patil
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Femoral Fractures ◽  
Long Bone ◽  
Femur Fractures ◽  
Articular Fractures ◽  
Dual Plating ◽  
Classi Cation ◽  
Excellent Functional Outcome ◽  
Operative Indications

Introduction: In this prospective cases series, we are reporting a mean 12-month follow up of the utilisation of dual plating technique for multi fragmentary articular distal femur fractures. Our technique consists of a lateral distal femoral locked plate and a low prole locked medial plate through a modied anterior (Swashbuckler) approach for the xation of C2, C3 fractures. Patients and Methods: 15 patients (9 males and 6 females) presented with supra condylar femoral fractures type C2/C3, according to Müller long bone classication and its revision, OA/OTA classication. These fractures were treated using dual plating through swashbuckler approach. They were followed up for clinical and radiological outcomes. Secondary outcomes included post-operative complications. Results: Mean time of radiological union in studied population was 18 weeks with a range of 14-24 weeks. We did not observe any post-operative varus angulation.12 out of 14 patients had good to excellent functional outcome. Fair outcome was reported in only two patients Conclusion: The technique of Dual plating xation using modied anterior approach (swashbuckler) for type C2,C3 distal femoral fractures is an efcient method of management. It has several advantages such as precise exposure, easy manipulation, anatomical reduction and stable xation. However, operative indications and principles should be strictly followed. The surgical technique must be perfect and the biomechanical qualities of the implants must be understood to prevent the development of major 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 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 Assessment of functional outcome of distal femur intra-articular fractures treated with locking compression plate

2019 ◽  
Vol 6 (1) ◽  
pp. 145
Author(s):  
Neetin Pralhad Mahajan ◽  
Ved Ashish Ravesh ◽  
Prasanna Kumar G. S. ◽  
Ajay Chandanwale ◽  
Lalkar Gadod
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Tertiary Care ◽  
Locking Compression Plate ◽  
Care Hospital ◽  
Excessive Bleeding ◽  
Femur Fractures ◽  
Medial Side ◽  
Articular Fractures ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Intra-articular distal femoral fracture makes up to 6% of all femur fractures. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. The locking compression plates have nowadays proven to be gold standard in treating both simple as well as complex intra-articular distal femur fractures. This study is to evaluate the complications, functional and anatomical outcome of distal femur fractures, treated by open reduction and internal fixation using distal femoral locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is<strong> </strong>a retrospective study of 30 patients with intra articular distal femur fractures operated with distal femur locking compression plate during the period of 2015 to 2018 in a tertiary care hospital with age range from 17 to 71 years and follow up till 2 years. Fractures were classified according to AO classification and functional outcome assessed by using Neer criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 10 cases had excellent score (33%), 16 cases (52%) had satisfactory score, 3 cases (11%) had unsatisfactory score and only one case had poor score.<strong> </strong>85.1% of patients were in between satisfactory to excellent results. Complications observed were excessive bleeding, difficulty in reduction, superficial infections, knee stiffness, malalignment and limb length discrepancy.</p><p class="abstract"><strong>Conclusions:</strong> The distal femur locking compression plate is a good implant to be used for distal femur intra-articular fractures. Early surgery, anatomical reduction and early mobilisation are the prerequisites for good functional outcome. Comminution and bone defect on the medial side needs pillar reconstruction by fibular bone graft.</p>

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.

scholarly journals Minimally invasive plate osteosynthesis with dual plating for periprosthetic distal femoral fractures following total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong-Geun Park ◽  
Hyunseong Kang ◽  
Jung-Kook Song ◽  
Jaehwang Lee ◽  
Joseph Y. Rho ◽  
...  
Keyword(s):  
Distal Femur ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Femoral Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Distal Femoral Fractures ◽  
Femur Fractures ◽  
Dual Plating ◽  
Total Knee

Abstract Introduction Adequate treatment for periprosthetic distal femur fractures is challenging because of various reasons, including severe osteoporosis and distal fragments that are too small or too distal. We have introduced a new surgical technique for dual plating of periprosthetic distal femur fractures following total knee arthroplasty (TKA) and determined the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) with a dual locking compression plate (LCP). Materials and methods Between January 2010 and July 2019, 18 patients [mean age, 74.8 (68–89) years; average follow-up period, 14.8 (12–43) months] underwent MIPO with distal femoral LCP laterally and proximal humeral internal locking system (PHILOS) medially for periprosthetic distal femoral fractures following TKA. The minimum follow-up was 1 year. The clinical and radiological outcomes were assessed using the modified WOMAC scores, knee range of motion, time to callus formation, time to union, and complications of malunion, nonunion, and shortening. Results The average time to union was 18.4 weeks (range, 10–51 weeks) and to callus formation was 7.8 weeks (range, 2–14 weeks). At the 1-year follow-up, the average JLETS was 37.6 (range, 24–53), average knee ROM was 110.3° (range, 80–135°), and average varus-valgus angles of the distal femur were 3.2° (range, −2.9–10.5°). No nonunion, broken plates, or implant failure occurred. Malunion occurred in three patients. Conclusion MIPO with dual LCP is a reliable method for stabilizing periprosthetic distal femoral fractures following TKA, with satisfactory bone union rates and low complication rates.

scholarly journals Minimally Invasive Plate Osteosynthesis with Dual Plating for Periprosthetic Distal Femoral Fractures Following Total Knee Arthroplasty

2020 ◽  
Author(s):  
Yong-Geun Park ◽  
Hyunseong Kang ◽  
Jung-Kook Song ◽  
Jaehwang Lee ◽  
Joseph Y. Rho ◽  
...  
Keyword(s):  
Distal Femur ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Femoral Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Distal Femoral Fractures ◽  
Femur Fractures ◽  
Dual Plating ◽  
One Year

Abstract Introduction: Adequate treatment for periprosthetic distal femur fractures is challenging because of various reasons, including severe osteoporosis and distal fragments that are too small or too distal. We have introduced a new surgical technique for dual plating of periprosthetic distal femur fractures following total knee arthroplasty (TKA) and determined the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) with a dual locking compression plate (LCP). Materials and methods: Between January 2010 and July 2019, 18 patients [mean age, 74.8 (68–89) years; average follow-up period, 14.8 (12–43) months)] underwent MIPO with distal femoral LCP laterally and proximal humeral internal locking system (PHILOS) medially for periprosthetic distal femoral fractures following TKA. The minimum follow-up was one year. The clinical and radiological outcomes were assessed using the modified WOMAC scores, knee range of motion, time to callus formation, time to union, and complications of malunion, nonunion, and shortening.Results: The average time to union was 18.4 weeks (range, 10–51 weeks) and to callus formation was 7.8 weeks (range, 2–14 weeks). At the one-year follow-up, the average JLETS was 37.6 (range, 24–53), average knee ROM was 110.3° (range, 80°–135°), and average varus-valgus angles of the distal femur were 3.2° (range, -2.9°–10.5°). No nonunion, broken plates, or implant failure occurred. Malunion occurred in three patients.Conclusion: MIPO with dual LCP is a reliable method for stabilizing periprosthetic distal femoral fractures following TKA, with satisfactory bone union rates and low complication rates.

scholarly journals Union rates and functional outcome of double plating of the femur: systematic review of the literature

2021 ◽  
Author(s):  
M. F. Lodde ◽  
M. J. Raschke ◽  
J. Stolberg-Stolberg ◽  
J. Everding ◽  
S. Rosslenbroich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Healing ◽  
Functional Outcome ◽  
Femoral Fractures ◽  
Periprosthetic Fractures ◽  
Level Of Evidence ◽  
Distal Femoral Fractures ◽  
Femur Fractures ◽  
Meta Analyses ◽  
Double Plating

Abstract Background The optimal treatment strategy for the surgical management of femur fractures and non-unions remains unknown. The aim of this study is to assess union rates, complications and outcome after femoral double plating. Treatment of shaft, distal, periprosthetic fractures and pathological proximal femur fractures as well as femoral non-unions with double plating were evaluated. Methods A systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was conducted. Published literature reporting on the treatment and clinical outcome of femoral fractures and non-unions with double plating was identified. In total, 24 studies with 436 cases of double plating, 64 cases of single plating, 84 cases of intramedullary nailing (IM), and 1 interfragmentary screw treatment met the inclusion criteria of this systematic review. The evaluated literature was published between 1991 and 2020. Results Double plating of femoral fractures achieved high healing rates and few complications were reported. It displayed significantly less intraoperative haemorrhage, shorter surgery time reduced risk of malunion in polytraumatised patients when compared to IM. Fracture healing rate of double-plating distal femoral fractures was 88.0%. However, there were no significant differences regarding fracture healing, complication or functional outcome when compared to single plating. Treatment of periprosthetic fractures with double plating displayed high healing rates (88.5%). Double plating of non-unions achieved excellent osseous union rates (98.5%). Conclusions The literature provides evidence for superior outcomes when using double plating in distal femoral fractures, periprosthetic fractures and femoral non-unions. Some evidence suggests that the use of double plating of femoral fractures in polytraumatised patients may be beneficial over other types of fracture fixation. Level of evidence IV.

Biomechanical and anatomical considerations for dual plating of distal femur fractures: a systematic literature review

2021 ◽  
Author(s):  
Graham J. DeKeyser ◽  
Anne J. Hakim ◽  
Dillon C. O’Neill ◽  
Carsten W. Schlickewei ◽  
Lucas S. Marchand ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Distal Femur ◽  
Femur Fractures ◽  
Dual Plating

scholarly journals Analytic study of functional outcome of retrograde intramedullary nailing for distal femoral fractures in adults

2021 ◽  
Vol 7 (4) ◽  
pp. 824
Author(s):  
Srujith Kommera ◽  
Pradeep Reddy ◽  
Saba Khaleel
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
X Rays ◽  
Fracture Union ◽  
Distal Femoral Fractures ◽  
Retrograde Intramedullary Nailing ◽  
Articular Fractures

<p class="abstract"><strong>Background: </strong>The purpose of this Study was to evaluate the clinical and functional outcome of retrograde intramedullary nailing for distal femur fractures.</p><p class="abstract"><strong>Methods: </strong>This 2 years observational study was done between December 2018 to January 2021, 60 patients with distal femoral fractures were surgically treated at our hospital using retrograde intramedullary nail. The patient was placed supine on fracture table with affected limb flexed to 60 degrees. Through a Transpatellar approach, the nail was introduced in retrograde method after serial reaming. Postoperatively knee range of motion was started immediately and weight bearing was progressed after signs of fracture union were noted on x-rays. The outcome was evaluated for time taken for fracture union, complications and functional outcome with various types of fractures.</p><p class="abstract"><strong>Results: </strong>All the fractures in the present study healed at an average of 13 weeks. However 25 to 40% of these patients underwent bone grafting primarily with reports of delayed union and non-union. Shortening occurred in two patients (3.33%) did affect the final functional outcome. average range of motion is 120 deg. for all fractures, 119 deg. for extra-articular fractures and 118 deg. for intra-articular fractures. Infection rates are low (0% to 8%).</p><p class="abstract"><strong>Conclusions: </strong>The study shows distal femoral fractures were common due to high velocity injuries, retrograde nailing is an excellent technique for management of distal femoral fractures as it promotes high rate of fracture union with less complications.</p>

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