EVALUATION OF FUNCTIONAL OUTCOME OF INTRA-ARTICULAR DISTAL FEMUR FRACTURES MANAGED USING PRECONTOURED LOCKING COMPRESSION PLATE

M SAEED; SU HAQ; M HUSSAIN; MZ KHAN

doi:10.54112/pjicm.v5i01.188

Authors

M SAEED Department of Orthopaedic and Spine Unit, Hayatabad Medical Complex Peshawar, Pakistan
SU HAQ Department of Orthopaedic and Spine Unit, Hayatabad Medical Complex Peshawar, Pakistan
M HUSSAIN Department of Orthopaedic and Spine Unit, Hayatabad Medical Complex Peshawar, Pakistan
MZ KHAN Department of Orthopaedic and Spine Unit, Hayatabad Medical Complex Peshawar, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i01.188

Keywords:

Intra-articular distal femur fracture, Locking compression plate, Functional outcome, Knee Society Score, Complications

Abstract

Background: Intra-articular distal femur fractures represent a challenging injury pattern due to complex anatomy, comminution, and involvement of the knee joint surface. Achieving stable fixation and early mobilization is essential for optimal recovery. Precontoured locking compression plates (LCP) have been developed to provide anatomical fixation and improved biomechanical stability. Objective: To evaluate the functional outcome of intra-articular distal femur fractures managed using a precontoured locking compression plate. Study Design: Descriptive study. Setting: Department of Orthopedic Surgery, Hayatabad Medical Complex, Peshawar, Pakistan. Duration of Study: From June 2024 to December 2024. Methods: A total of 45 patients aged 18 years and above with confirmed intra-articular distal femur fractures were included. All patients underwent open reduction and internal fixation using a precontoured locking compression plate. Functional outcomes were evaluated using the Knee Society Score (KSS) at three months postoperatively and categorized as excellent, good, fair, or poor. Postoperative complications, including infection and knee stiffness, were documented. Data were analyzed using SPSS version 23. Results: The mean age of patients was 44.84 ± 13.05 years, with males constituting 77.8% of the study population. Road traffic accidents were the most common cause of injury (73.3%). Functional outcome were excellent in 55.6% of patients, good in 33.3%, fair in 8.9%, and poor in 2.2%. The mean fracture union time was 16.53 ± 3.84 weeks. Postoperative complications included knee stiffness in 11.1% of patients, superficial infection in 4.4%, and deep infection in 2.2%. Conclusion: Open reduction and internal fixation of intra-articular distal femur fractures using precontoured locking compression plates yielded predominantly excellent to good functional outcomes with minimal complications. This method offers stable fixation and facilitates early mobilization, supporting its role as a reliable treatment option for complex distal femoral fractures.

References

Nester M, Borrelli Jr J. Distal femur fractures management and evolution in the last century. Int Orthop. 2023;47(8):2125–35. https://doi.org/10.1007/s00264-023-05782-1

Larsen P, Ceccotti AA, Elsoe R. High mortality following distal femur fractures: a cohort study including three hundred and two distal femur fractures. Int Orthop. 2020;44(1):173–7. https://doi.org/10.1007/s00264-019-04379-2

Coon MS, Best BJ. Distal femur fractures. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jul 31.

Richards JA, Berkay FB, Davis CM, Zamora RA. Intra-articular fracture pattern in intercondylar distal femur fractures: an analysis of frequency and major fracture fragments. Injury. 2021;52(4):967–70. https://doi.org/10.1016/j.injury.2020.11.061

Nino S, Parry JA, Avilucea FR, Haidukewych GJ, Langford JR. Retrograde intramedullary nailing of comminuted intra-articular distal femur fractures results in a high union rate. Eur J Orthop Surg Traumatol. 2022;32(8):1577–82. https://doi.org/10.1007/s00590-021-03041-8

Shi BY, Zukotynski BK, Upfill-Brown A, Brodke DJ, Kelley BV, Devana SK, et al. Fracture lines and patterns in intra-articular distal femur fractures. J Am Acad Orthop Surg. 2024;32(19):e1020–e1026. https://doi.org/10.5435/JAAOS-D-22-00805

Nauth A, Haller J, Augat P, Anderson DD, McKee MD, Shearer D, et al. Distal femur fractures: basic science and international perspectives. OTA Int. 2024;7(2S):e320. https://doi.org/10.1097/OI9.0000000000000320

Siddiqui YS, Mohd J, Abbas M, Gupta K, Khan MJ, Istiyak M. Technical difficulties and mechanical failure of distal femoral locking compression plate (DFLCP) in management of unstable distal femoral fractures. Int J Burns Trauma. 2021;11(1):9–16. No DOI found.

Agrawal AK, Bansal A, Rawat S, Kapadiya S, Desai S, Golwala P. Surgical management of distal femur fracture using anatomical locking compression plate. Int J Curr Res Rev. 2021;13(2):176–81. https://doi.org/10.31782/IJCRR.2021.13229

Singh SJ, Sree KU, Srinivas S, Pasula S. A study of functional outcome of distal femur fractures internally fixed with distal femur locking compression plate. ScienceRise: Med Sci. 2022;(3[48]):15–20. https://doi.org/10.15587/2519-4798.2022.257496

Rai B, Kar BK, Rai A, Behera S, Maurya RK. Analysis of functional outcomes and PROMs after internal fixation of intra-articular distal femur fracture. J Orthop Rep. 2025;4:100784. https://doi.org/10.1016/j.jorep.2025.100784

Kiran Kumar GN, Sharma G, Farooque K, Sharma V, Ratan R, Yadav S, et al. Locking compression plate in distal femoral intra-articular fractures: our experience. ISRN Orthop. 2014;2014:372916. https://doi.org/10.1155/2014/372916

Bandaru H, Shanthappa AH. Plating for intra-articular fractures of the distal femur: functional and radiological outcomes. Cureus. 2023;15(1):e33207. https://doi.org/10.7759/cureus.33207

Ali SD, Shah SKA, Aliuddin AM, Javed I, Azam KS, Naqvi SZG. Functional outcome of the distal femur pre-contour locking plate. J Liaquat Uni Med Health Sci. 2021;20(3):193–7. https://doi.org/10.22442/jlumhs.2021.00794