*Corresponding author:Gyanendra Kumar Jha, Lecturer Department of Orthopaedics, College of Medical Sciences, Bharatpur Chitwan, Nepal
Received: February 27, 2018; Published: March 13, 2018
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Introduction: Fractures of distal femur are one of the most prevalent fractures encountered in high-velocity trauma which are associated with high morbidity and mortality if not managed well. The isolated fracture can itself lead to complications such as Acute Respiratory Distress Syndrome (ARDS) and pulmonary embolism (PE). This necessitates early stabilization of fractures. Open reduction and internal fixation (ORIF) with locking compression plate is the treatment of choice for closed fractures of the distal femur. Distal femur anatomic contoured locking compression plate (LCP) has shown to give one of the best results regarding recovery, fracture union, return to work and the functional outcome. We present our experience of management of distal femur fracture at our centre.
Methods: 30 cases of supracondylar femur fracture were treated by ORIF with LCP between 1st October 2014 to 30th September 2016 at our tertiary level trauma centre. The patients were evaluated clinically and radiologically for outcomes. All patients were followed up for an average of 6 months. The outcome was assessed using Neer’s Score. The fracture was considered united clinically when there was no pain on palpation, no discomfort on full weight bearing. Radiologically fracture was considered united when serial roentgenograms demonstrated bone trabaculae is crossing the fracture site. The functional outcome was evaluated by Neer’s knee score criteria.
Result: In our study 30 cases of supracondylar femur fractures were treated. 18 patients were males, and 12 patients were females. The median age was 34.97 years ranging from 18 to 62 years? All the fractures were caused by road traffic accidents. 19 patients were with fracture on the right side and 11 on the left side. Using Neer’s scoring system excellent outcome was seen in 53.33%, good in 36.67%, fair in 6.67% and failure in 3.33%. The range of motion of the knee was excellent to very good. Gait and weight bearing after the complete union was satisfactory.
Conclusion: The method of treatment is standard with good exposure of fracture fragments, less operative time and good functional and radiological outcome. LCP is an important modality in the treatment of fractures around knee especially when the fracture is severely communited and in situations of osteoporosis.
Keywords: Supracondylar fracture; locking compression plate; Open reduction internal fixation
Abbreviations: ARDS: Acute Respiratory Distress Syndrome; PE: Pulmonary Embolism; ORIF: Open Reduction and Internal fixation; LCP: Locking Compression Plate