Role of Locked Compression Plates in Distal Femoral Fractures

Abstract

Distal femoral fractures occur in approximately one-tenth the rate of proximal femur fractures and make up to 6% of all femur fractures, there is a bimodal distribution of fractures based on age and gender. Most high-energy distal femoral fractures occur in males between 15 and 50 years, while most low-energy fractures occur in osteoporotic women >50 years. (1) The most common classification system used for distal femoral fractures is the AO/OTA (Orthopaedic Trauma Association) system. The distal femur is number 33 in this system, and the fracture is then classified based on the amount of articular involvement and comminution into A (extra-articular), B (partial articular) and C (complete articular) fracture. Each is further classified into 1, 2, or 3 based on the amount and location of comminution. (2) Treatment goals include anatomical reduction of the articular surface, restoration of limb alignment, early postoperative knee range of motion (important for articular cartilage nutrition), and early patient mobilization. (3) Procedures should be kept as simple as possible to minimize surgical time, blood loss, and physiologic stress. Although anatomic restoration is important for intraarticular fractures, metaphyseal fractures are best managed by attempts to primarily achieve stability rather than anatomic reduction. (4)