Swapna Pran Saikia1, Pranjal Tahbildar2
BACKGROUND
The most challenging fractures faced by orthopaedic surgeons are the distal fractures of femur, especially the intraarticular distal femoral fractures. These fractures have been classified according to Orthopaedic Trauma Association (OTA) 33-C3. Distal femoral fractures account to 4-7% of all femoral fractures and are less common compared to hip fractures.
T
he aim of the study is t o study the functional outcome of fracture of intraarticular distal femur treated with distal femur
locking compression plate.
MATERIALS AND METHODS
This study is a pr
ospective study which co mprised of 30 patients of intra articular distal femur fracture AO classification 33 C3
who were treated by locking compression plate at Jorhat Medical College and Hospital , Jorhat, Assam. This study was conducted
during February 2015 to April 2017. The functional outcome was studied using Neer’s score, outcome of radiology and
complication with fracture fixation using LCP.
RESULTS
Out of 30 patients, 22 were males (73.3%) and 8 were femal
es (26.7%). 18 patients had fracture right hand side and 12
patients had left handed fractures. A 19 years old was the youngest patient and 72 years was the oldest patient. About 70%
patients had sustained road traffic accidents and 10% had sustained fall from a height. Four days was the average trauma to
operative interval, 22 patients were operated e xtensile lateral approach and 8 patients were operated by swashbuckler approach.
12 weeks was the average weightbearing duration, 21 weeks was average time for fracture healing. 10 patients had C1 (33.3%),
12 patients had C2 (40%) and 8 patients had C3 (26 .7%) type of fracture according to AO classification. Among 30 patients,
13 patients have shown excellent results, 7 patients have good results, 5 fair results and 5 poor results. Primary bone grafting
was done in 4 patients for severely comminuted type C3 fracture . S econdary bone grafting was done in 2 patients who had
delayed union at 4 month, 1 patient showed sign of union on 9 th month, 1 patient showed non union treated with secondary
bone grafting at 9 th month with signs of union at 12 month s . Two patie nts developed infection on 4 th post operative day which
was resolved with antibiotics. Four patients developed knee stiffness.
CONCLUSION
The locking compression plates with option of locked screws has provided the means to increase the rigidity of fixation in
intraarticular distal femoral fractures. Better functional outcome was achieved using lock ing compression plate for intra articular
di s tal femoral fractures with proper physiotherapy.
