Management of distal femoral fracture by distal femoral locking plate outcome

Abstract

Introduction: Distal femur fracture has been routinely fixed with a single lateral locking plate. This method of fixation in intra-articular distal femur fractures has proved to give a higher outcome of varus collapse as well as higher rates of mal-union due to inadequate fixation of the medial aspect of the distal femur. In elderly persons distal femur fractures are associated with trivial fall due to osteoporosis and can cause difficulty in fracture fixation. Materials and Methods: This is a prospective study conducted in the Department of Orthopedic Surgery, BSMMU, Dhaka, Bangladesh from January to June 2022. A total of 60 patients with distal femoral fractures were included in the study as per the inclusion criteria outlined previously. On admission detailed examination of the patients was carried out after hemodynamic stabilization. Then standard Antero-Posterior and Lateral view X-Rays are taken, and the fracture configuration noted. Computerized Tomography is also taken when needed to assess the exact alignment of the fragments. The fracture is classified using the following classification. Results: The total number of patients was 60 with 36 males and 24 females. The youngest age in our study was 19 and the oldest age is 65. Mode of injury were 48 cases due to RTA (80%), 7 cases due to accidental fall (11.7%) and 5 case due to fall of heavy object (8.3%). The average months of follow up were 10. 6 months with longest of 23 months and shortest of 3 months. All patients were able to bear full weight postoperatively except for six patients. Average time to union was 18 weeks with a range from 10 weeks to 36 weeks. Mean range of motion was 0⁰ -106.8⁰. Using the HSS scoring system, 73.3% had good to excellent results. Conclusion: In our study, the results are encouraging with 73.3% of the patients having good to excellent results. Therefore, locking compression plate has a significant advantage with excellent results in treating distal femoral fractures. However, accurate positioning and fixation are required to produce satisfactory results.