Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis

Ki-Chul Park; Kyu-Sung Chung; Joon-Ki Moon

doi:10.12671/jkfs.2012.25.1.13

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Park, Chung, and Moon: Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(1): 13-19.

Published online: 31 January 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.1.13

Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis

Ki-Chul Park, M.D., Kyu-Sung Chung, M.D., Joon-Ki Moon, M.D.

Department of Orthopedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Address reprint requests to: Ki-Chul Park, M.D. Department of Orthopedic Surgery, Guri Hospital, Hanyang University College of medicine, 249-1, Gyomoon-dong, Guri 471-701, Korea. Tel: 82-31-560-2318, Fax: 82-31-557-8781, kcpark@hanyang.ac.kr

Received 21 July 2011 Revised 30 October 2011 Accepted 15 November 2011

Abstract

Purpose

To analyze the result of distal femur fracture treatment with minimally invasive plate osteosynthesis (MIPO) using a locking compression plate (LCP).

Materials and Methods

From December 2004 to April 2010, 33 patients with distal femur fractures were treated by MIPO with a locking compression plate. The reduction state and bone union time was checked radiologically. The clinical outcome was evaluated by the Schatzker and Lambert criteria.

Results

The mean bone union time was 16.3 weeks (10~22 weeks). There were 3 nonunions, 2 broken plates, 1 superficial infection, 7° of valgus angulation in 1 case, and 1.5 cm limb shortening in 1 case. Except for the 3 nonunion cases, according to the Schatzker and Lambert criteria, results were graded as excellent in 11 cases, good in 14 cases, and moderate in 5 cases.

Conclusion

The treatment of distal femoral fracture by MIPO with a locking compression plate resulted in good functional and radiological outcomes, but it has problems, such as broken plates and nonunion. Accurate surgical technique and appropriate treatment will be needed according to fracture type.

Keywords: Distal femur fracture, Locking compression plate, Minimally invasive plate osteosynthesis

Figures and Tables

Fig. 1

(A, B) A 66-year-old woman with communited, distal femur fracture by traffic accident (AO-OTA classification 32-C1).

(C, D) Radiographs show a postoperative state which is reduced and internal fixation.

(E, F) Follow-up radiographs after 6 months show bony union with good alignment.

(G, H) Clinical photographs after 6 months show nearly full range of motion on knee joint.

Fig. 2

(A, B) A 57-year-old man with extraarticular metaphyseal fragmented wedge, distal femur fracture injured by traffic accident (AO-OTA classification 33-A2).

(C, D) Radiographs show a postoperative state which is reduced and internal fixation.

(E, F) Follow-up radiographs after 20 weeks show a nonunion state.

(G, H) Radiographs show a second operation state via removal of previous implant, autogenous iliac bone graft and reimplantation.

(I, J) Follow-up radiographs after 4 months from second operation show bony union.

Table 1

Comparison of clinical outcomes

^*Fisher exact test.

Table 2

Patient demographics, clinical and radiographic outcomes

ROM: Range of motion, AP: Anteriorposterior, Lat: Lateral.

Table 3

The Schazker and Lambert criteria

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