SURGICAL OUTCOME OF EXTRA ARTICULAR FRACTURES OF DISTAL FEMUR FIXED WITH DISTAL FEMUR LOCKING PLATE
Authors: Naik Dr. R Murali Krishna , Nagaraju Dr. G , N Dr.Ebel Raj 
Published: March 2023

INTRODUCTION: The distal femoral fractures accounts for the 7% of all femoral fractures and can be attributed to be caused by two types of injuries A. High velocity vehicular accidents commonly observed in young patients. B. Low energy mechanisms such as trivial fall in the older population especially women. A thorough history of the trauma and clinical examination is required in all patients having distal femur fracture , after sustaining fracture of femur at any level there is signicant bleeding into the surrounding soft tissues of the thigh and could lead to hypovolemic shock,and so indicators of shock should be checked for and immediately treated.Since last two decades incidence of distal femoral fracture has increased a lot due to rise in road trafc accidents.The management of distal femur fractures is challenging because of various factors like the bone quality,age of the patient, articular surface involvement, presence of small fragments, xation system and associated soft tissue injuries.There has not been a single management strategy that has solved all the issues that has arisen because of this injury. Before 1970 ,most of the supracondylar femur cases were treated non operatively.However angulatory deformities , knee joint stiffness,loss of knee joint motion and the complication due to prolongedbed rest necissitated better treatment options.The Open reduction and Internal xation have become standard treatment in the recent years with excellent outcomes obtained with locking compression plate.The LCPs are fracture xation devices with threaded screw holes , that allow screws to thread to the plate and function as a xed angle device. Since the plate does not depend on the friction created at the bone-plate interface to provide stability ,the plate does not have to contact the bone directly which helps in preserving the periosteal blood supply.The LCP is a single beam construct where strength of its xation is equal to the sum of all screw-bone interfaces rather than a single screw's axial stiffness or pull out resistance as seen in non - locking plates. This study intends to obtain the functional outcome of extra articular fractures of distal femur treated by open reduction and internal xation with distal femur locking plate. MATERIALS AND METHODS: The present study was undertaken at the Department of Orthopaedics, RANGARAYA MEDICAL COLLEGE , kakinada after obtaining ethical clearance. Based on the inclusion and exclusion criteria, a total of 20 patients with extraarticular distal femur fractures were sampled and included in the study. A thorough evaluation of the patient was conducted following stabilisation and admission. The fracture conguration was then observed on conventional Antero-Posterior and Lateral views of the radiographs. . Limb immobilization is done in a Thomas splint , by using either upper or lower tibial pin traction to maintain the length & alignment of the fractures. When necessary, computer tomography was performed to determine the precise alignment of the fragments. These fractures were categorised using AO Muller's system. Open reduction and internal xation is done with distal femur locking plate. The nal analysis of the Neer's score RESULTS: revealed that 60 percent (12 patients) had excellent outcomes, while 30 percent (6 patients) had satisfactory results. It was unsatisfactory in 10 percent of cases (2 patients), with no patients failing. CONCLUSION: In the treatment of distal femoral fractures, the LCP condylar plate is the preferred option, especially in Type A fractures where we have observed higher Neer scores. Additionally, LCP avoids periosteal vessels from being compressed. Although it may not entirely resolve the enduring issues of any fractures with old age , such as malunion and nonunion, it is a useful approach in the care of these fractures