Plating for Intra-articular Fractures of the Distal Femur: Functional and Radiological Outcomes

Background and objective Intra-articular fractures of the distal femur pose a significant surgical difficulty. These fractures are challenging to repair, and surgery is frequently advised for a successful outcome. The distal femoral fractures make up between 4-6% of all femoral fractures and account for less than 1% of all fractures. When compared to the single screw's axial stiffness or pullout resistance, as is the case with unlocked plates, the locking compression plate (LCP) is a single beam construct whose strength of fixation is equal to the sum of all screw-bone contacts. Against this backdrop, the current study was conducted for evaluating the functional outcomes of distal femoral fractures treated with LCP fixation.Methodology We conducted an observational study at a tertiary care facility in Kolar spanning a period of three years, from January 2019 to January 2022. We included all patients aged more than 18 years, who were diagnosed with distal femoral fractures [only those classified as type C according to the AO Foundation/Orthopedic Trauma Association (AO/OTA) classification]. Patients with terminal illnesses, revision of previous surgery, fractures with neurovascular injuries, and those diagnosed with pathological fractures were excluded from the study. The included patients were treated by LCP and discharged on postoperative day 10 after suture removal. The first follow-up was at the first month and subsequent follow-ups were done at three and six months, and the functional outcomes were assessed by using Neer's score for straight leg raises. Radiographs with fading fracture lines and callus formation on three-fourths of the cortices were regarded as indicators of fracture healing.Results Among the 30 study participants, 80% were males. The mean time for the radiological union was 15 weeks. In this study, there were no instances of infection or angular deformity greater than 5 degrees. About 80% of the study participants had ranges of motion (ROM) above 120 degrees at the end of the six-month follow-up period; 12 cases had an excellent score (40%), 15 cases (50%) had a satisfactory score, two cases (6.7%) had an unsatisfactory score, and only one case had poor score. Common complications observed were excessive bleeding, difficulty in reduction, superficial infections, and knee stiffness.Conclusion For patients with distal femoral fractures, the LCP treatment can result in good functional and radiological outcomes with fewer complications.