Anatomical Plate Fixation for Distal Femur Fracture

Moon, Eun Sun; Lee, Keun Bae; Jeong, Jong Wook

Abstract

The fractures of the distal femur which involve supracondylar or intercondylar region are difficult to manage because occasionally, severe soft tissue damage, comminution, intra-articular extension of fracture and injury to the quadriceps mechanism lead to unsatisfactory results in many case. Recently, early anatomical reduction, rigid internal fixation and early exercise of the knee joint has been recommended. A clinical and radiological analysis was performed on 48 cases with fractures of distal femur who had been treated by anatomical plate and followed for minimum 1 year from April 1990 to July 1997. According to AO classification, 22 cases(45.8%) were type A, 1 case(2.1%) were type B and 25 cases(52.1%) were type C. The functional results by Sanders-Swiontkowski-Rosen-Helfet rating system were showed excellent in 15(31.3%), good in 17(35.4%), fair in 13(27.0%) and poor in 3 cases(6.3%). The overall results were seen to be excellent or to be good in 32 cases(66.7%) and results were worse in type C, old age, open fractures. The most common complication was limited range of motion of the knee under 90 degrees in 10 cases, including nonunion caused by loosening of screw in 1 case, metal failure in 1 case and shortening in 1 case. And other complications were delayed union in 4 cases and angular deformity in 2 cases. In conclusion, ideal indication for anatomical plating may be a metaphyseal fracture of distal femur with or without involvement of articular surface in young adult. Anatomical plate may be alternative one among the fixation devices for distal femur fractures.