Evaluation of Results of Open Reduction and Internal Fixation (ORIF) of Fracture of Distal End of Femur with Intra-Articular Extension
https://doi.org/10.5704/MOJ.2111.012
- Author:
Amin TK
1
;
Patel I
1
;
Patel MJ
1
;
Kazi MM
1
;
Kachhad K
1
;
Modi DR
1
Author Information
1. Department of Orthopaedics, Smt NHL Municipal Medical College, Ahmedabad, India
- Publication Type:Journal Article
- Keywords:
intra-articular, distal femur, internal fixation, plating
- From:Malaysian Orthopaedic Journal
2021;15(No.3):78-83
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Fractures of the distal femur account for 0.4%
of all fractures. They involve about 7% of all femur
fractures, with bimodal age distribution, commonly occur
during high-velocity trauma of motor vehicle accidents in the
younger group of patients and are frequently associated with
other skeletal injuries. The treatment of distal femoral
fractures has evolved from conservative treatment to more
aggressive operative treatment. The aim is to achieve and
maintain a good reduction of the joint to allow early active
mobilisation, thus minimising the joint stiffness and severe
muscular atrophy encountered in the conservative treatment.
Materials and methods: This is a retrospective study of 25
patients with distal femur fracture with intra-articular
extension treated with open reduction and internal fixation
with DFLP, admitted at our institute between 2016 to 2019,
with a minimum follow-up of six months.
Results: In our study, 19 (76%) patients had excellent to
good results. Three (12%) patients had fair outcomes, and
three (12%) patients had poor outcomes according to Neer’s
score. The average time for bone union in closed fractures
was earlier (4.25 months) than open fractures, averaging
5.86 months. The outcome was almost similar between
closed and open fractures. There were 2 (8%) cases of
infection in the early post-operative period, 7 (12%) patients
suffered from knee stiffness, and there were 3 (12%) cases
with a pre-operative bone loss that required bone grafting.
Conclusion: Management of complex intra-articular distal
femur fracture has always been a challenge. Anatomical
reduction of articular fragments and rigid fixation of these
fractures are a must. DFLP provides angular stability with
multiple options to secure fixation of both metaphyseal and
articular fragments with the restoration of the joint congruity,
limb length, alignment and rotation, allowing early
mobilisation and aggressive physiotherapy without loss of
fixation, resulting in gratifying functional outcome and low
complication rate.
- Full text:16.2021my1204.pdf
