Clinical effect of locking compression plate via posterolateral approach in the treatment of distal femoral fractures: a
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RESEARCH ARTICLE
Open Access
Clinical effect of locking compression plate via posterolateral approach in the treatment of distal femoral fractures: a new approach Wenzhao Xing1, Wei Lin2, Jia Dai3, Zhigang Kong1, Yanfeng Wang1, Lei Sun1, Zhiguo Zhang1 and Liang Sun1*
Abstract Background: Distal femur fractures are difficult to manage, and the selection of implant approach for internal fixation remains controversial. This study explores the clinical outcome of treating distal femoral fractures with a locking compression plate using a posteriolateral novel approach. Methods: Twenty patients with distal femoral fractures were included in our study, and all patients underwent fixation of the fracture using a locking compression plate through a posterolateral approach. The postoperative fracture healing time, complications, and functional recovery were observed and recorded. The joint function was categorized according to the Kolmert functional criteria. Results: All patients were followed up for an average of 12 months, and all incisions healed by first intention. Among the all patients, 19 patients achieved fracture healing 3 to 4 months after surgery. The remaining 1 patient with distal femoral C3 comminuted fracture achieved partial fracture healing 15 months after surgery, and bone grafting was needed. All knees can reach the state of straightening, and the postoperative excellent rate was 90%. Among them, 8 patients had maximal flexion of more than 120°, 10 patients had flexion between 90° and 120°, and 2 other patients had flexion of 70° and 40°. Conclusions: Fixation of the fracture using a locking compression plate through a posterolateral approach seemed to be an acceptable surgical option for treatment of distal femoral fractures. Keywords: Femoral fracture, Internal fixation, Posterolateral approach, Locking compression plate
Background Fractures of the distal femur are severe injuries that present many clinical challenges to the orthopedic surgeon [1, 2]. These fractures are often unstable and comminuted and tend to occur in elderly or multiply injured patients [2]. For long, gold standard treatment modality for fixation of the distal femur fractures was angle blade plate (ABP), compression screw, and side plate devices such as dynamic condylar screw (DCS). Insertion of blade plates is technically demanding; DCS and ABP require removal of a large amount of bone for * Correspondence: [email protected] 1 Department of Orthopaedics, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China Full list of author information is available at the end of the article
insertion; condylar buttress plates (CBP) lack the stability of fixed angle devices and are prone to varus collapse or screw failure [3, 4]. Retrograde intramedullary nails (IMNs) were not sufficient for stabilizing fragmented articular fractures [5, 6]. Nowadays, anatomically contoured locking plates and locking screws are being used more commonly for surgical fixation during distal femur fractures. Current
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