A prospective study of functional outcome of distal femur fractures by locking plate

Abstract

Introduction: In last few decades, rapid industrialization and the fast pace of life have brought both comforts and catastrophe like road traffic accidents and crippling many young lives. High velocity road traffic accidents are responsible for distal femur fractures more commonly observed in the young and middle aged patients. This necessitates early stabilization of fractures. Internal fixation is the choice of treatment in fractures distal femur and Locking Condylar plate has shown to give one of the best results in terms of recovery, fracture union, return to work and the functional outcome. Aims and objective: To study the outcome of open reduction and locking plate fixation of fractures of distal end of femur and to evaluate the effectiveness and complications of the Locking plate fixation method of treatment of fractures of distal end of femur. Material and Method: It is a prospective observational study. Conducted in patients admitted to Department of Orthopedics‘ at BLDEU‘S Shri B.M.Patil‘s Medical College, Hospital and Research Centre, Vijayapura with diagnosis of distal Femur fracture. The patients were informed about study in all respects and informed written consent was obtained. Period of study was between November 2017 to May 2019. Follow up period was for 6 months. Data was analysed by SPSS v21 and p-value <.05 was considered statistically significant. Results: in our study 22 cases studied in our series were with 18 males and 4 females‘ patients. 15 of the fractures were caused by road traffic accidents (RTA), 6 were due to fall and 1 was due to assault. 15 patients were with fracture on right side and 7 on left side. 1 was Muller‘s type A1, 6 were Muller‘s type A2, 4 were Muller‘s type A3, 1 was Muller‘s type C1, 6 were Muller‘s type C2 and remaining 4 were with Muller‘s type C3 fracture. The duration of time required by patients to bear full weight was with mean of 15.8 weeks oftime. The radiological union was seen at median of 17 weeks following surgery. Average flexion in the study of the limb was 110 º angles with more than 50% patients having knee range of motion more than 120º. The outcome in form of regaining the knee function is assessed using NEER‘s scoring system. The median NEER‘s score in study was 94.5. Among 22 patients included, 12 patients showed excellent outcome, 6 with good and 4 with fair outcome at the follow-up. Poor outcome was found in patients with Muller‘s type C3 and type A3 fractures. Conclusion: To conclude, Locking Compression Plate is an important armamentarium in treatment of fractures around knee especially when fracture is severely comminuted and in situations of osteoporosis. Fixation with locking condylar plate showed more effectiveness in severely osteoporotic bones, shorter post-operative stay, faster recovery, earlier union rates and excellent functional outcome compared to alternative procedures in other studies. Further study in large number of patients is required to comment regarding disadvantages and complications.