Sang-Eun Park; Hyun-Taek Kang; Young-Yul Kim; Jae-Jung Jeong; Jung-U Lee; Weon-Yoo Kim

doi:10.12671/jkfs.2011.24.4.321

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Original Article
Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate: Sang-Eun Park, M.D., Hyun-Taek Kang, M.D., Young-Yul Kim, M.D., Jae-Jung Jeong, M.D., Jung-U Lee, M.D., Weon-Yoo Kim, M.D.; Journal of the Korean Fracture Society 2011;24(4):321-327.
DOI: https://doi.org/10.12671/jkfs.2011.24.4.321
Published online: October 30, 2011

Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea.

Address reprint requests to: Weon-Yoo Kim, M.D. Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, 520-2, Daehung-dong, Joong-gu, Daejeon 301-723, Korea. Tel: 82-42-220-9530, Fax: 82-42-221-0429, weonkim@hotmail.com

• Received: January 4, 2011 • Revised: February 27, 2011 • Accepted: August 28, 2011

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Abstract
REFERENCES

Abstract

Purpose
To report the clinical outcome of polyaxial locking plate (Noncontact bridging (NCB) plate (Zimmer, Warsaw, Indiana)) for the treatment of distal femur fracture with minimal invasive percutaneous periosteal osteosynthsis (MIPPO) technique.
Materials and Methods
Between February 2008 to April 2010, twenty six patients (11 men, 15 women), twenty eight cases diagnosed as distal femoral fractures are enrolled in this retrospective study. The mean age of the patients was 63 years (34 to 85) and the mean follow-up was 20.3 months (12 to 32). According to the AO/ASIF classification, 15 fractures were type A, 1 type B and 9 type C. And there were 3 periprsthetic fractures around knee. The analysis of the clinical and radiologic outcome were performed by Sanders functional evaluation scale and radiologic follow up after operation, respectively.
Results
Among 28 cases, 25 cases united without additional operation. According to Sanders functional evaluation scale, there were 11 excellent, 9 good, 4 fair, 2 poor. As complications, there were 1 knee stiffness, 1 delayed union, 1 implant failure with refracture, 1 implant loosening. Three patients except one knee stiffness, underwent a second LISS plating using NCB plate and and bone grafting, resulting in a satisfactory final outcome.
Conclusion
Internal fixation using polyaxial locking plate with MIPO technique may be one of the most effective methods for the treatment of distal femoral fractures.
Key words: Distal femoral fracture, Internal fixation, Polyaxial locking plate

REFERENCES

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Fig. 1

(A) The initial radiographs and 3D CT of a 60-yearold female who sustained a Type C2 supracondylar fracture of the distal femur showing a intra-articular supracondylar fracture.

(B) Postoperative 16 weeks radiographs shows solid union.

Fig. 2

A 44-year-old male suffering from multiple fractures, including left distal femoral open comminuted fracture (AO classification C3) was treated with open reduction and internal fixation using LCP. After 2 months, osteosynthesis with autologous iliac bone grafting was performed for scanty callus and remained bony defect which is augmented by medial NCB plate. Bony union was obtained during follow-up.

(A) Initial AP radiograph.

(B) Preoperative three-demensional CT scan.

(C) First postoperative (Internal fixation using LCP) AP radiograph.

(D) Second postoperative (Internal fixation and augmentation using NCB plate) AP radiograph.

(E) Last follow-up clinical photograph.

Fig. 3

(A) The initial radiographs of a 60-year-old female who sustained a Type A1 supracondylar fracture of the Lt. distal femur.

(B) The postoperative radiographs show the supracondylar fracture was reduced and fixed with 15 hole NCB plate.

(C) Postoperative 8 weeks, she suffered refracture with metallic breakage due to minor trauma during ambulation.

(D) Reoperation was done using same length NCB plate and wiring and showed callus formation.

Table 1

Summary of patient dermographics

TA: traffic accident.

Table 2

Functional results by Sanders et al

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo
Journal of the Korean Fracture Society.2023; 36(1): 25. CrossRef
Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta‐analysis
Byung-Ho Yoon, In Keun Park, Youngwoo Kim, Hyoung-Keun Oh, Suk Kyu Choo, Yerl-Bo Sung
Archives of Orthopaedic and Trauma Surgery.2021; 141(2): 225. CrossRef

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Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate

J Korean Fract Soc. 2011;24(4):321-327. Published online October 31, 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.4.321

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Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate

Fig. 1 (A) The initial radiographs and 3D CT of a 60-yearold female who sustained a Type C2 supracondylar fracture of the distal femur showing a intra-articular supracondylar fracture. (B) Postoperative 16 weeks radiographs shows solid union.

Fig. 2 A 44-year-old male suffering from multiple fractures, including left distal femoral open comminuted fracture (AO classification C3) was treated with open reduction and internal fixation using LCP. After 2 months, osteosynthesis with autologous iliac bone grafting was performed for scanty callus and remained bony defect which is augmented by medial NCB plate. Bony union was obtained during follow-up. (A) Initial AP radiograph. (B) Preoperative three-demensional CT scan. (C) First postoperative (Internal fixation using LCP) AP radiograph. (D) Second postoperative (Internal fixation and augmentation using NCB plate) AP radiograph. (E) Last follow-up clinical photograph.

Fig. 3 (A) The initial radiographs of a 60-year-old female who sustained a Type A1 supracondylar fracture of the Lt. distal femur. (B) The postoperative radiographs show the supracondylar fracture was reduced and fixed with 15 hole NCB plate. (C) Postoperative 8 weeks, she suffered refracture with metallic breakage due to minor trauma during ambulation. (D) Reoperation was done using same length NCB plate and wiring and showed callus formation.

Fig. 1

Fig. 2

Fig. 3

Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate

Table 1

Summary of patient dermographics

TA: traffic accident.

Table 2

Functional results by Sanders et al

Table 1 Summary of patient dermographics

TA: traffic accident.

Table 2 Functional results by Sanders et al