J Korean Fract Soc.  2016 Jul;29(3):206-212. 10.12671/jkfs.2016.29.3.206.

Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report

• Jang SA
• Byun YS
• Han IH
• Shin D

• KMID: 2344094
• DOI: http://doi.org/10.12671/jkfs.2016.29.3.206

Abstract

Generally, lateral plating is used for a comminuted fracture of the distal femur. However, in some cases, it has been shown that using a medial plate is necessary to achieve better outcome. Nevertheless, there are no available anatomical plates that fit either the distal medial femoral condyle or fracture fixation, except for the relatively short plate developed for distal femoral osteotomy. We found that locking compression plate-proximal lateral tibia (LCP-PLT) fits anatomically well for the contour of the ipsilateral medial femoral condyle. Moreover, LCP-PLT has less risk of breaking the thread holes since it rarely needs to be bent. We report a plastic bone model study and two cases of distal femoral fractures fixed with medial plating using LCP-PLT.

Keyword

Distal femur; Medial plating; Locking compression plate proximal lateral tibia

MeSH Terms

Femoral Fractures*
Femur
Fracture Fixation
Fractures, Comminuted
Osteotomy
Plastics
Tibia*
Plastics

Figure

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  Fig. 1 Photographs of the femur bone model (3B Scientific, Hamburg, Germany) with various plates on medial condyle, locking compression plate-proximal lateral tibia (LCP-PLT), tomoFix-medial distal femur plate (TomoFix-MDF), proximal humerus internal locking plate system (PHILOS), LCP-medial distal tibia plate (LCP-MDTP), LCP-distal metaphyseal tibia (LCP-DMT), and LCP-distal tibia T (LCP-T) plate, in order from upper left corner.

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  Fig. 2 Photographs of the femur bone model (3B Scientific, Hamburg, Germany) showing the application of locking compression plate- proximal lateral tibia (LCP-PLT) on appropriate position. A: Distal posterior hole.

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  Fig. 3 Photographs of the femur bone model (Synbone, Malans, Switzerland) with the application of locking compression plate-proximal lateral tibia (LCP- PLT) on appropriate position. A: Distal posterior screw directed to the intercondylar notch, B: 2nd row screw reached the lateral femoral condyle without penetration into the intercondylar notch.

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  Fig. 4 Radiographs of the right knee and the right femur showing preexisting lateral plate and comminuted fracture of the right distal femur.

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  Fig. 5 Radiographs and photographs of the right femur at 12 months after the surgery showing good fracture healing and good range of motion of the right knee.

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  Fig. 6 Radiographs of the left knee and the coronal section of computed tomography scan of the left knee showing severely impacted medial condyle fracture.

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  Fig. 7 Radiographs and photographs of the left knee at 14 weeks after surgery showing good fracture healing and good range of motion of the left knee.

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