Dynamic Locked Plating of Distal Femur Fractures

Background Distal femur fractures account for less than 1% of all fractures and 3%– 6% of all femur fractures. Epidemiological studies indicate 2 primary distributions of patients: elderly individuals with low energy mechanisms such as a fall from standing, and younger patients with high-energy mechanisms such as motor vehicle accidents. Fixation of the distal femur fracture with lateral locked plate had a nonunion rate between 0 to 32%. The concept of “Dynamic” Locked Plates, has been proposed to decrease construct stiffness & improve callus formation. Objective A systematic review and meta-analysis of literature to assess the outcomes of dynamic locked plate of distal femora fractures. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion Our systematic review and meta-analysis showed different method of distal femur locked plate dynamyzation. DLP of distal femur increased interfragmentery micro motion, decrease construct stiffness and improve healing & union rate of distal femur fractures. Finally it should be noticed that the orthopedic surgeon should be qualified to utilize either techniques & the choice depends on the preoperative planning & method of fixation available which leads to fracture union on time without complications.

Evaluation of the Results of Internal Fixation of Olecranon Fracture: Comparative Study between Olecranon Plate and Screws Versus Tension Band and K Wires

Background: Olecranon fractures constitute a large proportion of injuries about the elbow. Several fracture patterns are recognized, with each pattern lending itself to a different treatment modality ranging from conservative treatment to fixation by different methods like tension band wiring, olecranon plate, intramedullary screw with or without tension band, and single Rush pin fixation. This study aimed to evaluate and compare the result of fixation of olecranon fracture tension band with K-wire and posterior olecranon special non locked plate fixation. Materials and Methods: This study included 30 patients, prospectively of simple olecranon fracture. Patients were randomly classified into two equal groups; group I was managed by tension band and K wires, while group I was managed by special non locked olecranon plate and screws. Results: No significant differences were found between both groups in DASH score, range of motion, improvement rate, radiological outcomes and return to previous activities. Conclusion: There were no significant differences between the two-fixation method regarding to DASH, ROM, radiological outcomes, and return to previous activity but rate of hardware removal was higher in tension band and K wires than posterior olecranon special non locked plate fixation.