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Original Article
Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture
Sung Won Cho, M.D., Sang Ho Ha, M.D., Gwang Chul Lee, M.D., Woong Hee Kim, M.D.
Journal of the Korean Fracture Society 2013;26(3):205-211.
DOI: https://doi.org/10.12671/jkfs.2013.26.3.205
Published online: July 15, 2013

Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Korea.

Address reprint requests to: Sang Ho Ha, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, shha@chosun.ac.kr
• Received: November 28, 2012   • Revised: March 20, 2013   • Accepted: June 11, 2013

Copyright © 2013 The Korean Fracture Society. All rights reserved.

This is anOpen Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    To analyze the clinical and radiologic results of minimally invasive plate osteosynthesis (MIPO) for distal femur fractures using a locking compression plate (LCP) and to evaluate its usefulness.
  • Materials and Methods
    From May 2006 to April 2011, 23 patients (24 cases) with distal femur fracture were treated by MIPO with a LCP and followed-up for at least 12 months. Mean age was 61.6 years (35-80 years). Union time and post-operative alignment were measured on radiograph, and clinical function was evaluated by range of motion (ROM), Knee Society Score and complications.
  • Results
    In 22 patients (23 cases) except for 1 case, bony union was obtained after an average of 18 weeks (12-26 weeks). The mean ROM was 124 degrees (80-135 degrees). According to the Knee Society Score, there were 12 excellent, 8 good, 1 fair and 2 poor results and the mean score was 87.5 (60-98). Postoperative complications were nonunion in 1 case, ankylosis in 1 case, malunion in 2 cases and superficial wound infection in 2 cases.
  • Conclusion
    The treatment of distal femoral fracture with MIPO using a LCP was considered a useful method which can result in satisfactory clinical and radiologic outcomes if there is accurate understanding about the surgical techniques and appropriate procedures involved.
  • 1. Button G, Wolinsky P, Hak D. Failure of less invasive stabilization system plates in the distal femur: a report of four cases. J Orthop Trauma, 2004;18:565-570.
  • 2. Davison BL. Varus collapse of comminuted distal femur fractures after open reduction and internal fixation with a lateral condylar buttress plate. Am J Orthop (Belle Mead NJ), 2003;32:27-30.
  • 3. Ehlinger M, Adam P, Abane L, Arlettaz Y, Bonnomet F. Minimally-invasive internal fixation of extra-articular distal femur fractures using a locking plate: tricks of the trade. Orthop Traumatol Surg Res, 2011;97:201-205.
  • 4. Ehlinger M, Adam P, Arlettaz Y, et al. Minimally-invasive fixation of distal extra-articular femur fractures with locking plates: limitations and failures. Orthop Traumatol Surg Res, 2011;97:668-674.Article
  • 5. Frigg R, Appenzeller A, Christensen R, Frenk A, Gilbert S, Schavan R. The development of the distal femur Less Invasive Stabilization System (LISS). Injury, 2001;32:Suppl 3. SC24-SC31.Article
  • 6. Giles JB, DeLee JC, Heckman JD, Keever JE. Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. J Bone Joint Surg Am, 1982;64:864-870.Article
  • 7. Han SB, Choi IC, Lee SH, Suh DH, Cho HJ. Minimal invasive plate osteosynthesis for distal femoral fracture. J Korean Fract Soc, 2006;19:11-16.
  • 8. Janzing HM, Stockman B, Van Damme G, Rommens P, Broos PL. The retrograde intramedullary nail: prospective experience in patients older than sixty-five years. J Orthop Trauma, 1998;12:330-333.Article
  • 9. Kregor PJ, Stannard JA, Zlowodzki M, Cole PA. Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma, 2004;18:509-520.
  • 10. Kregor PJ, Stannard J, Zlowodzki M, Cole PA, Alonso J. Distal femoral fracture fixation utilizing the Less Invasive Stabilization System (L.I.S.S.): the technique and early results. Injury, 2001;32:Suppl 3. SC32-SC47.Article
  • 11. Krettek C, Müller M, Miclau T. Evolution of minimally invasive plate osteosynthesis (MIPO) in the femur. Injury, 2001;32:Suppl 3. SC14-SC23.
  • 12. Krettek C, Schandelmaier P, Miclau T, Bertram R, Holmes W, Tscherne H. Transarticular joint reconstruction and indirect plate osteosynthesis for complex distal supracondylar femoral fractures. Injury, 1997;28:Suppl 1. A31-A41.Article
  • 13. Mize RD. Surgical management of complex fractures of the distal femur. Clin Orthop Relat Res, 1989;(240):77-86.Article
  • 14. Park KC, Chung KS, Moon JK. Treatment of distal femur fracture with minimally invasive locking compression plate osteosynthesis. J Korean Fract Soc, 2012;25:13-19.Article
  • 15. Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br, 2002;84:1093-1110.
  • 16. Schatzker J. Fractures of the distal femur revisited. Clin Orthop Relat Res, 1998;(347):43-56.
  • 17. Schatzker J, Home G, Waddell J. The Toronto experience with the supracondylar fracture of the femur, 1966-72. Injury, 1974;6:113-128.
  • 18. Schütz M, Müller M, Krettek C, et al. Minimally invasive fracture stabilization of distal femoral fractures with the LISS: a prospective multicenter study. Results of a clinical study with special emphasis on difficult cases. Injury, 2001;32:Suppl 3. SC48-SC54.
  • 19. Siliski JM, Mahring M, Hofer HP. Supracondylar-intercondylar fractures of the femur. Treatment by internal fixation. J Bone Joint Surg Am, 1989;71:95-104.
  • 20. Wagner M. General principles for the clinical use of the LCP. Injury, 2003;34:Suppl 2. B31-B42.
  • 21. Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ. Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005). J Orthop Trauma, 2006;20:366-371.
Fig. 1
Indirect reduction and temporary plate fixation with reduction forceps and K-wires.
jkfs-26-205-g001.jpg
Fig. 2
(A, B) The initial radiograph of 68-year-old female shows comminuted metaphyseal fracture of distal femur (AO/OTA classification A3).
(C, D) Radiographs show a postoperative state.
(E, F) At postoperative 20 weeks, radiograph shows maintenance of reduction and bony union.
(G, H) At postoperative 20 weeks, range of motion of knee is good.
jkfs-26-205-g002.jpg
Fig. 3
(A, B) The initial radiograph of 69-year-old female shows simple spiral metaphyseal fracture of distal femur (AO/OTA classification A1).
(C, D) Post operative radiographs shows 7° valgus alignment: the epiphyseal screws are not parallel to the joint line.
(E, F) At postoperative 24 weeks, radiograph shows maintenance of reduction and bony union.
jkfs-26-205-g003.jpg
Table 1
Patient Demographics, Clinical and Radiographic Outcomes
jkfs-26-205-i001.jpg

KSS: Knee society score, ROM: Range of motion, AP: Anteriorposterior, Lat: Lateral, F: Female, M: Male, TA: Traffic accident, Supf.: Superficial.

Table 2
Comparison of Clinical Outcomes
jkfs-26-205-i002.jpg

KSS: Knee society score, ROM: Range of motion.

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
    • Surgical Treatment of AO/OTA 33-C Intra-Articular Distal Femoral Fractures through Parapatellar Approach
      Suk Kyu Choo, Sung Tan Cho, Hyoung Keun Oh
      Journal of the Korean Fracture Society.2022; 35(1): 1.     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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      Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture
      J Korean Fract Soc. 2013;26(3):205-211.   Published online July 31, 2013
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    Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture
    Image Image Image
    Fig. 1 Indirect reduction and temporary plate fixation with reduction forceps and K-wires.
    Fig. 2 (A, B) The initial radiograph of 68-year-old female shows comminuted metaphyseal fracture of distal femur (AO/OTA classification A3). (C, D) Radiographs show a postoperative state. (E, F) At postoperative 20 weeks, radiograph shows maintenance of reduction and bony union. (G, H) At postoperative 20 weeks, range of motion of knee is good.
    Fig. 3 (A, B) The initial radiograph of 69-year-old female shows simple spiral metaphyseal fracture of distal femur (AO/OTA classification A1). (C, D) Post operative radiographs shows 7° valgus alignment: the epiphyseal screws are not parallel to the joint line. (E, F) At postoperative 24 weeks, radiograph shows maintenance of reduction and bony union.
    Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture

    Patient Demographics, Clinical and Radiographic Outcomes

    KSS: Knee society score, ROM: Range of motion, AP: Anteriorposterior, Lat: Lateral, F: Female, M: Male, TA: Traffic accident, Supf.: Superficial.

    Comparison of Clinical Outcomes

    KSS: Knee society score, ROM: Range of motion.

    Table 1 Patient Demographics, Clinical and Radiographic Outcomes

    KSS: Knee society score, ROM: Range of motion, AP: Anteriorposterior, Lat: Lateral, F: Female, M: Male, TA: Traffic accident, Supf.: Superficial.

    Table 2 Comparison of Clinical Outcomes

    KSS: Knee society score, ROM: Range of motion.


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