Abstract

A Study on Functional Outcome of Comminuted Supracondylar Fracture Femur Treated by Plating with Fibular Bone Grafting

Introduction: Distal femur fractures are difficult, complex injuries that can result in devastating outcomes. The intra-articular injury can vary from a simple split to extensive comminution. Articular involvement can lead to posttraumatic arthritis. These fractures constitute 4% to 7% of all femur fractures. There is a bimodal distribution defined by the mechanism of injury. The goal of any treatment is to maintain or restore the congruity of the articular surface and restore the length and alignment of the femur and subsequently the limb.

Materials and methods: A prospective study carried out from February 2015 to February 2016 in government medical college Thiruvananthapuram, involving 24 patients with comminuted supracondylar fracture femur (OTA/AO type A2, A3, C2 and C3) treated by distal femoral LCP with fibular bone grafting. The period of follow up was 12 months and the outcome was assessed using Neer’s score.

Results: 24 patients which included 16 males and 8 females with mean age of 45.7 showing a bimodal pattern in age distribution were studied. Mechanism of injury included both road traffic accident and fall in which 14 patients (58.3%) sustained the fracture due to RTA and 10 patients (41.7%) sustained injury due to fall affecting both sides equally. In the study according to AO/OTA classification there were 7 A2, 2 A3, 6 C2 and 9 C3 fractures. The average duration of hospital stay was 10 days with time delay to surgery of average 5 days and average duration of surgery 104 min. 14 patients (58.3%) had more than 100° of knee flexion and 10 patients (41.7%) had less than 100 degree. The minimum flexion obtained was 70° and maximum being 120°. There were 2 patients with varus angulation of 10 and 15° and shortening of 1 and 2 cm each. Complication included 1 case of non-union and 1 case of superficial wound infection which subsided with antibiotics. 3 cases with extensor lag with an average of 6°. Outcome assessment using Neer’s score showed 14 patients with excellent, 5 patients with good, 3 patients with fair and 2 patients with poor outcome.

Conclusion: Distal femoral LCP with fibular strut graft appears to be a good treatment option for comminuted supracondylar fracture of femur.


Author(s):

Sabarisree M1, Jyothiprasanth M2, Suresh Babu3 and Nithin Sunku4



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