Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture

Sung Won Cho; Sang Ho Ha; Gwang Chul Lee; Woong Hee Kim

doi:10.12671/jkfs.2013.26.3.205

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Cho, Ha, Lee, and Kim: Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture

Original Article

Journal of the Korean Fracture Society 2013; 26(3): 205-211.

Published online: 15 July 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.3.205

Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture

Sung Won Cho, M.D., Sang Ho Ha, M.D., Gwang Chul Lee, M.D., Woong Hee Kim, M.D.

Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Korea.

Address reprint requests to: Sang Ho Ha, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, shha@chosun.ac.kr

Received 28 November 2012 Revised 20 March 2013 Accepted 11 June 2013

(open-access):

This is anOpen 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 analyze the clinical and radiologic results of minimally invasive plate osteosynthesis (MIPO) for distal femur fractures using a locking compression plate (LCP) and to evaluate its usefulness.

Materials and Methods

From May 2006 to April 2011, 23 patients (24 cases) with distal femur fracture were treated by MIPO with a LCP and followed-up for at least 12 months. Mean age was 61.6 years (35-80 years). Union time and post-operative alignment were measured on radiograph, and clinical function was evaluated by range of motion (ROM), Knee Society Score and complications.

Results

In 22 patients (23 cases) except for 1 case, bony union was obtained after an average of 18 weeks (12-26 weeks). The mean ROM was 124 degrees (80-135 degrees). According to the Knee Society Score, there were 12 excellent, 8 good, 1 fair and 2 poor results and the mean score was 87.5 (60-98). Postoperative complications were nonunion in 1 case, ankylosis in 1 case, malunion in 2 cases and superficial wound infection in 2 cases.

Conclusion

The treatment of distal femoral fracture with MIPO using a LCP was considered a useful method which can result in satisfactory clinical and radiologic outcomes if there is accurate understanding about the surgical techniques and appropriate procedures involved.

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

Figures and Tables

Fig. 1

Indirect reduction and temporary plate fixation with reduction forceps and K-wires.

Fig. 2

(A, B) The initial radiograph of 68-year-old female shows comminuted metaphyseal fracture of distal femur (AO/OTA classification A3).

(C, D) Radiographs show a postoperative state.

(E, F) At postoperative 20 weeks, radiograph shows maintenance of reduction and bony union.

(G, H) At postoperative 20 weeks, range of motion of knee is good.

Fig. 3

(A, B) The initial radiograph of 69-year-old female shows simple spiral metaphyseal fracture of distal femur (AO/OTA classification A1).

(C, D) Post operative radiographs shows 7° valgus alignment: the epiphyseal screws are not parallel to the joint line.

(E, F) At postoperative 24 weeks, radiograph shows maintenance of reduction and bony union.

Table 1

Patient Demographics, Clinical and Radiographic Outcomes

KSS: Knee society score, ROM: Range of motion, AP: Anteriorposterior, Lat: Lateral, F: Female, M: Male, TA: Traffic accident, Supf.: Superficial.

Table 2

Comparison of Clinical Outcomes

KSS: Knee society score, ROM: Range of motion.

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