Is Distal Femur Locking Plate a Superior Implant in Distal Femur Fracture?

Vignesh  Jayabalan; Ganesan Ram  Ganesan; Anil  Chander

doi:10.4236/ojo.2015.59035

Anil Chander, Ganesan Ram Ganesan^*, Vignesh Jayabalan

Abstract: In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.

Keywords: Distal Femur, Supacondylar Femur, Distal Femur Locking Compression Plate, Distal Femur Nail

Cite this paper: Chander, A. , Ganesan, G. and Jayabalan, V. (2015) Is Distal Femur Locking Plate a Superior Implant in Distal Femur Fracture?. Open Journal of Orthopedics, 5, 258-263. doi: 10.4236/ojo.2015.59035.

References

[1] Kannus, P., Parkkari, J., Sievanen, H., et al. (1996) Epidemiology of Hip Fractures. Bone, 18, 57S.
http://dx.doi.org/10.1016/8756-3282(95)00381-9

[2] Dy, C.J., McCollister, K.E., Lubarsky, D.A. and Lane, J.M. (2011) An Economic Evaluation of a Systems-Based Strategy to Expedite Surgical Treatment of Hip Fractures. The Journal of Bone & Joint Surgery, 93, 1326-1334.
http://dx.doi.org/10.2106/JBJS.I.01132

[3] Müller, M.E., Nazarian, S., Koch, P. and Schatzker, J. (1990) The Comprehensive Classification of Fractures of Long Bones. Springer, Berlin.
http://dx.doi.org/10.1007/978-3-642-61261-9

[4] Müller, M.E., Allgower, M., Schneider, R. and Willenegger, H. (1979) Manual of Internal Fixation. Springer, Berlin.
http://dx.doi.org/10.1007/978-3-642-96505-0

[5] Neer II, C.S., Grantham, S.A. and Shelton, M.L. (1967) Supracondylar Fracture of the Adult Femur. The Journal of Bone & Joint Surgery, 49A, 591-613.

[6] Mize, R.D., Bucholz, R.W. and Grogan, D.P. (1982) Surgical Treatment of Displaced Comminuted Fractures of the Distal End of the Femur. The Journal of Bone & Joint Surgery, 64A, 871-879.

[7] Moore, T.J., Watson, T., Green, S.A., Garland, D.E. and Chandler, R.W. (1987) Complications of Surgically Treated Supracondylar Fractures of the Femur. Journal of Trauma-Injury Infection & Critical Care, 27, 402-406.
http://dx.doi.org/10.1097/00005373-198704000-00010

[8] Bell, K.M., Johnstone, A.J., Court-Brown, C.M. and Hughes, S.P.F. (1992) Primary Knee Arthroplasty for Distal Femoral Fractures in Elderly Patients. The Journal of Bone & Joint Surgery, 74B, 400-402.

[9] Markmiller, M., Konrad, G. and Südkamp, N. (2004) Femur-LISS and Distal Femoral Nail for Fixation of Distal Femoral Fractures: Are There Differences in Outcome and Complications? Clinical Orthopaedics and Related Research, 426, 252-257.

[10] Christodoulou, A., Terzidis, I., Ploumis, A., Metsovitis, S., Koukoulidis, A. and Toptsis, C. (2005) Supracondylar Femoral Fractures in Elderly Patients Treated with the Dynamic Condylar Screw and the Retrograde Intramedullary Nail: A Comparative Study of the Two Methods. Archives of Orthopaedic and Trauma Surgery, 125, 73-79.
http://dx.doi.org/10.1007/s00402-004-0771-5

[11] Sanders, R., Swiontokowski, M., Rosen, H. and Helfet, D. (1991) Double Plating of Comminuted Unstable Fractures of the Distal Part of the Femur. The Journal of Bone & Joint Surgery, 73A, 341-346.

[12] Roby, D. and Bucholz, R. (1989) Management of Complex Fractures of the Distal Femur. Clinical Orthopaedics and Related Research, 240, 77-86.

[13] Mize, R.D., Bucholz, R.W. and Grogan, D.P. (1982) Surgical Treatment of Displaced Comminuted Fractures of the Distal End of the Femur. The Journal of Bone & Joint Surgery, 64A, 871-879.

[14] Marti, R.K., Schuller, H.M. and Raaymakers, E.L. (1989) Intertrochanteric Osteotomy for Non-Union of the Femoral Neck. The Journal of Bone & Joint Surgery (British Volume), 71, 782-787.

[15] Butler, M.S., Brumback, R.J., Ellison, T.S., Poka, A., Bathon, G.H. and Burgess, A.R. (1991) Interlocking Intramedullary Nailing for Ipsilateral Fractures of the Femoral Shaft and Distal Part of the Femur. The Journal of Bone & Joint Surgery, 73A, 1492-1502.

[16] Giles, J.B., Delee, J.C., Heckman, J.D. and Keever, J.E. (1982) Supracondylar-Intercondylar Fractures of the Femur Treated with a Supracondylar Plate and Lag Screw. The Journal of Bone & Joint Surgery, 64A, 864-870.

[17] Pritchett, J.W. (1984) Supracondylar Fractures of the Femur. Clinical Orthopaedics and Related Research, 184, 173- 177.
http://dx.doi.org/10.1097/00003086-198404000-00027