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. 2013 Mar;4(1):16-20.
doi: 10.1177/2151458513496254.

Clinical outcomes of distal femoral fractures in the geriatric population using locking plates with a minimally invasive approach

Hitendra K Doshi  1 , Png Wenxian, Maitra Vaarun Burgula, Diarmuid Paul Murphy
Affiliations

Clinical outcomes of distal femoral fractures in the geriatric population using locking plates with a minimally invasive approach

Hitendra K Doshi et al. Geriatr Orthop Surg Rehabil. 2013 Mar.

Abstract

Background: Fractures of the distal femur comprise 4% to 6% of all femoral fractures. Elderly patients are predisposed to low-energy fractures due to osteoporosis. Treatment of these fractures in the elderly group remains a challenge. Our hypothesis is that locking plates inserted with minimally invasive plate osteosynthesis (MIPO) techniques will produce better results compared to those inserted by open technique. The objective of this study is to evaluate the clinical outcomes of MIPO technique using locking plates in the elderly patients.

Materials and methods: A total of 24 elderly patients (mean age 73 years) with distal femur fractures treated using the MIPO technique (2007-2010) were reviewed retrospectively. Parameters analyzed included classification of fracture, time to fracture union, knee range of motion, functional knee score (Knee Society Score-Functional) at 6 months, and other significant complications. One patient was lost to follow-up.

Results: In all, 88% of the fractures were extraarticular. The mean time to union was 13.48 (range: 8-28) weeks. Mean range of motion achieved at 6 months and beyond was 100° ranging from 0 to 30 (extension) to 90 to 140 (flexion). Functional knee scores at 6 months from fixation were satisfactory (mean score 88.8). There were no cases of implant failure, nonunion, and infection. In all, 6 (25%) patients developed deep vein thrombosis (DVT) in the early postoperative period, all of which were below the level of the knee joint.

Conclusion: Locking plates inserted using MIPO techniques in elderly patients with distal femur fractures appear to be promising based on clinical outcome measurements. However, there was a high incidence of DVT noted.

Keywords: distal femur fracture; geriatric population; locking plates; minimally invasive.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Long spiral distal femur fracture.
Figure 2.
Figure 2.
Union at 6 months following a locking plate (minimally invasive plate osteosynthesis technique).
Figure 3.
Figure 3.
Graph 1: functional knee score grading.
See this image and copyright information in PMC

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