Deepak Jain1, Raghav Arora2, Rajnish Garg1, Pankaj Mahindra1, Harpal S Selhi1. 1. Department Of Orthopaedics, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, 141001, India. 2. Department Of Orthopaedics, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, 141001, India. pgorthodmc@gmail.com.
Abstract
PURPOSE: This prospective study evaluated the functional outcome and union rates of open distal femoral fractures managed with anatomic lateral locking plates. METHODS: Thirty-four patients with open distal femur fractures with mean age of 40.8 years (range 20-65 years) were included in the study. Patients with Gustilo-Anderson grade IIIC fractures and those managed with non-locking modalities were excluded. In total, 70.6% (n = 24) of the fractures were Type IIIA and 55.9% (n = 19) were AO/OTA Type C3 fractures. In 23.5% (n = 8) patients, knee spanning external fixator was applied initially before definitive fixation. Patients were followed up for a mean period of 11.6 months (range 8-22.5 months). Functional outcome was evaluated using Sanders Score. RESULTS: In the primary plating group, 69.2% (n = 18) fractures united at an average of 27 weeks (range 21-40 weeks), while eight patients had non-union and required bone grafting. All eight patients with external fixator underwent lateral locked plating with bone grafting and united at an average time of 39.6 weeks (range 31-50 weeks). There were two cases each of infection and screw failure. The final mean Sanders Score was 30.1 (range19-40) with 73.5% (n = 25) patients having good to excellent functional outcomes. CONCLUSIONS: Lateral locking plates offer excellent stability to allow fracture union in open distal femoral fractures. A proactive approach to identify and manage potential healing difficulties is advisable to promote bone healing.
PURPOSE: This prospective study evaluated the functional outcome and union rates of open distal femoral fractures managed with anatomic lateral locking plates. METHODS: Thirty-four patients with open distal femur fractures with mean age of 40.8 years (range 20-65 years) were included in the study. Patients with Gustilo-Anderson grade IIIC fractures and those managed with non-locking modalities were excluded. In total, 70.6% (n = 24) of the fractures were Type IIIA and 55.9% (n = 19) were AO/OTA Type C3 fractures. In 23.5% (n = 8) patients, knee spanning external fixator was applied initially before definitive fixation. Patients were followed up for a mean period of 11.6 months (range 8-22.5 months). Functional outcome was evaluated using Sanders Score. RESULTS: In the primary plating group, 69.2% (n = 18) fractures united at an average of 27 weeks (range 21-40 weeks), while eight patients had non-union and required bone grafting. All eight patients with external fixator underwent lateral locked plating with bone grafting and united at an average time of 39.6 weeks (range 31-50 weeks). There were two cases each of infection and screw failure. The final mean Sanders Score was 30.1 (range19-40) with 73.5% (n = 25) patients having good to excellent functional outcomes. CONCLUSIONS: Lateral locking plates offer excellent stability to allow fracture union in open distal femoral fractures. A proactive approach to identify and manage potential healing difficulties is advisable to promote bone healing.
Entities:
Keywords:
Distal femur fracture; Lateral locking plate; Non-union; Open fracture
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