Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures

Oog Jin Shon; Moon Soo Kwon; Chul Hyun Park

doi:10.12671/jkfs.2012.25.4.269

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Shon, Kwon, and Park: Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(4): 269-276.

Published online: 19 October 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.4.269

Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures

Oog Jin Shon, M.D., Ph.D., Moon Soo Kwon, M.D., Chul Hyun Park, M.D., Ph.D.

Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Chul Hyun Park, M.D., Ph.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4240, chpark77@naver.com

Received 28 July 2011 Revised 9 January 2012 Accepted 20 May 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare results of minimally invasive plate osteosynthesis using a locking compression plate and a periarticular locking plate in distal femur fractures.

Materials and Methods

We retrospectively reviewed 31 consecutive femoral fractures who treated by minimally invasive plate osteosynthesis from April 2006 to May 2009. Sixteen patients were treated using a locking compression plate (group A) and 15 patients were treated using a periarticular locking plate (group B).

Results

The mean operation time was 78 minutes and 76 minutes (p=0.273), and the mean radiation exposure time was 1.9 minutes and 2.3 minutes (p=0.001) in the group A and B, respectively. The plate bending during operation was performed in 4 cases of group A. The knee range of motion was 117.5° and 118.2° (p=0.825), and the Lysholm score was 81.3 and 81.8 (p=0.723) in the group A and B, respectively. Schazker criteria showed more than good grade in 93.8% of group A and in 93.3% of group B (p=1.0).

Conclusion

No significant differences in clinical results were observed between the two groups. However, a lower anatomical compliance was showed in the locking compression plate, and a higher risk of radiation exposure was showed in the periarticular locking plate.

Keywords: Distal femoral fracture, Minimally invasive plate osteosynthesis, Locking compression plate, Periarticular locking plate

Figures and Tables

Fig. 1

(A) Patients were placed supine and the uninjured leg was in the lowered position for fluoroscopy.

(B) Supracondylar towel bumps made of rolled surgical towels were placed in the area posterior to the supracondylar region.

Fig. 2

(A) For the locking compression plate in distal femur procedure, we used a guiding block for distal fixation.

(B) For the Zimmer® periarticular locking plate procedure, a Jig system was used.

Fig. 3

The coronal fracture fragment angle was defined as the angle between the line of the femoral shaft and the distal intercondylar line.

Fig. 4

A 72-year-old woman presented with an AO/OTA type C3 distal femoral fracture on the (A) anterior-posterior and lateral view and (B) 3-dimensional computed tomography.

(C) The fracture was treated with minimally invasive plate osteosynthesis with locking compression plate in distal femur.

(D) The fracture had healed at 19 weeks after the operation.

Fig. 5

A 51-year-old man presented with an AO/OTA type C2 distal femoral fracture on the (A) anterior-posterior and lateral view and (B) 3-dimensional computed tomography.

(C) The fracture was treated with minimally invasive plate osteosynthesis with Zimmer® periarticular locking plate.

(D) The fracture was healed at 18 weeks after the operation.

Fig. 6

The distal locking screw penetrated the medial femoral cortex in the (A) locking compression plate in distal femur group and (B) Zimmer® periarticular locking plate (ZPLP) group. However, only the ZPLP group complained of pain by screw irritation.

Table 1

Patient Demographic Data

Values are presented as mean (range) or number. LCP-DF: Locking compression plate in distal femur, ZPLP: Zimmer® periarticular locking plate, M: Male, F: Female.

Table 2

Schatzker Criteria

LCP-DF: Locking compression plate in distal femur, ZPLP: Zimmer® periarticular locking plate.

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