A Prospective Study on Surgical Management of Closed Distal End Femoral Fracture in Adults Using Distal Femur Locking Compression Plate

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Abstract

Background: Distal Femur fractures are a highly incident complex case and pose a challenge to the treatingorthopedician.Aims and Objectives: The aims and objectives of this study were to assess radiological union of distal femoralfractures by open reduction and internal fixation with locking compression plate, To study the functionaloutcome for internal fixation of fractures of the distal end femur by Locking Compression Plate and Toevaluate the effectiveness and complications of distal end femur fractures treated with Locking CompressionPlate based on, time till union, rate of infection, and fixation failures, functional outcome using NEER’S SCORE.Materials and Methods: The present study was done from April 2017 to April 2018 which comprised offifteen patients with closed Distal end Femoral Fractures who where treated by Locking Compression plate.Overall final outcome was assessed in terms of radiological union, clinical assessment and regaining the lostknee function using NEER’S Score.Results: Out of 15 patients, 12 patients were males and 3 patients were females.Out of 15 patients, 14 were due toRTA. Maximum number of cases was of Muller type C2-60%. Internal fixation was considered after patientsgeneral and medical condition was stabilized. The average operative time was 90 minutes. The size of plate wasselected based on the type of fracture. 6 to 10 hole plate were used most commonly. Of 15 patients, 10(66.66%)showed radiological union within 16 weeks. 9 (60%) of the patients achieved weight bearing at the end of 14weeks. Average flexion in this study was 100 degree with more than 3 (20%) patients having knee range ofmotion more than 110 degree. 1 Patient had stiff knee. More than 80% patients were extensor lag less than 5degree. 2 patients had VARUS MALALIGNMENT out of 15 patients.Results according to NEER’S SCORE wereExcellent in 20% patients, Good in 60% , Satisfactory in 6.6% and unsatisfactory in 13.3% patients. 2 patients hadsuperficial infection and 1 patient had delayed union.Conclusion: Locking compression plate is an optimal tool for Distal end femoral fractures. It provides rigidfixation in the region of femur, where a wide canal, thin cortices and frequently poor bone stock make fixationdifficult.
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应用股骨远端锁定加压钢板治疗成人闭合性股骨远端骨折的前瞻性研究
背景:股骨远端骨折是一种高度偶然性的复杂病例,对骨科医生的治疗提出了挑战。宗旨及目标:本研究的目的和目的是评估股骨远端骨折切开复位和锁定加压钢板内固定的放射学愈合,研究锁定加压钢板内固定股骨远端骨折的功能结果,并根据愈合时间、感染率和固定失败率评估锁定加压钢板治疗股骨远端骨折的疗效和并发症。功能结果采用never’s评分。材料与方法:本研究于2017年4月至2018年4月完成,包括15例闭合性股骨远端骨折患者,均采用锁定加压钢板治疗。使用NEER 'S评分评估放射学愈合、临床评估和膝关节功能恢复的总体最终结果。结果:15例患者中,男性12例,女性3例。在15名患者中,14名患者接受了toRTA治疗。最大病例数为Muller型C2-60%。在患者一般情况和病情稳定后考虑内固定。平均手术时间为90分钟。根据骨折类型选择钢板的尺寸。最常用的是6 ~ 10孔板。15例患者中,10例(66.66%)在16周内放射愈合。9例(60%)患者在14周结束时达到体重。本研究的平均屈曲度为100度,超过3例(20%)患者膝关节活动范围超过110度。1患者膝关节僵硬。80%以上患者伸肌滞后小于5度。15例患者中2例出现内翻畸形。NEER’s评分结果:优20%,良60%,满意6.6%,不满意13.3%。2例发生浅表感染,1例延迟愈合。结论:锁定加压钢板是治疗股骨远端骨折的最佳工具。它在股骨区域提供刚性固定,在该区域,宽管、薄皮质和通常较差的骨存量使固定变得困难。
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