2019, Vol. 3 Issue 1, Part C
The incidence of distal femur fractures has increased significantly during recent decades, and the incidence is highest in older women and in adolescent boys and men. The present study was undertaken to assess the functional and radiological outcome of internal fixation of fractures of distal end femur surgically managed by distal femoral locking compression plate. Also to evaluate the effectiveness and complications of distal end femur fractures treated with locking compression plate based on rate of union, time till union, rate of infection, varus and valgus mal-alignment and fixation failures. A prospective study consisted of n = 32 subjects with distal femur fractures admitted to the Department of Orthopaedics, Mahatma Gandhi Memorial Hospital, Warangal, was conducted in the Department of Orthopaedics, Kakatiya Medical College, Warangal, Telangana, India for a period of one year. The subject’s age ranged from 18 – 74 years. Of n = 32 subjects, 28 cases showed radiological union within 20 weeks and the average time for union was 16 weeks. Delayed union was found in 2 cases. 2 cases operated for supracondylar fracture non-union with implant failure had delayed union which took 13 months for union. Weight bearing without pain was achieved in n = 30 cases with mean time 12.2 weeks. 8 cases had limb length shortening: < 1 cm in 3 cases and 1 – 2 cm in 1 patient, more than 2 cm shortening was seen in 4 cases. Functional outcome was assessed at the end of 1 year in terms of regaining the lost knee function using NEER’s Scoring System. Out of n = 32 subjects, n = 30 (93.75%) had excellent to fair results with no major complications. The functional outcome was Excellent in n = 19 (59.38%) subjects, Good in n = 6 (18.75%), Fair in n = 5 (15.63%) and Poor in only 2 (6.25%) cases.
Conclusion: The locking compression plate represents an evolutionary approach to the surgical management of distal femoral fractures, but it does not completely solve the age old problems of non-union and mal-union. It is an economical and safe fixation system for the treatment of fracture of any part of the long bones. The rate of union as well as increased range of motion, improved healing rate, restoration of articular surface, better biomechanical stability, decreased complication rates, decreased incidence of re-operation, early rehabilitation makes it a good treatment option.
Therefore, if preoperative planning and biomechanical principles are followed, LCP may provide excellent fixation in difficult situations offering good treatment option.