Short term analysis of the Functional and Radiological outcome of distal femoral fractures fixed with locking compression plate by Minimally Invasive Plate Osteosynthesis (MIPO) technique: A prospective study

Sivaprasath, J (2014) Short term analysis of the Functional and Radiological outcome of distal femoral fractures fixed with locking compression plate by Minimally Invasive Plate Osteosynthesis (MIPO) technique: A prospective study. Masters thesis, Kilpauk Medical College, Chennai.

[img]
Preview
Text
220200414sivaprasath.pdf

Download (3MB) | Preview

Abstract

AIM: To prospectively analyse the clinical and radiological outcome of distal femur fractures fixed with locking compression plate by minimally invasive plate osteosynthesis (MIPO) technique. MATERIALS AND METHODS: 20 patients with distal femur fractures were evaluated in between July 2011 to November 2013. Radiographs of knee were taken in AP & Lateral views. AO/Muller type B and C3 were excluded from the study. All the patients were operated under spinal/epidural anaesthesia and the patient position was supine with knee in 60-70 degrees flexion. Distal femur was exposed using modified lateral approach (minimally invasive) and the fracture was reduced by indirect reduction techniques. We used locking compression plate to fix the fracture. Post operative radiographs were taken to assess the reduction and implant position.post operative rehabilitation was started from the 1st post operative day. Patients were followed up at every 4-6 weeks interval to assess fracture union, limb length, alignment, knee range of movements and functional outcome. Hammer et al grading was used to assess union and the knee society scoring system was used to assess the functional outcome. OBSERVATIONS AND RESULTS: We followed up 20 patients in the age group of 20 – 80 years for the period of 6 to 18 months (mean =12 months). Among them, 13 patients were males and 7 females; 12 patients sustained RTA and 8 had a self fall. 5 patients sustained an open fracture with 2 had grade I and 3 had grade II injuries. 15 of them had type A fractures (A1-3, A2-4, A3-8) and remaining 5 had type C fractures (C1-1, C2-4). The mean interval for surgery was 5 days and the mean operating time was 101 minutes. The length and rotation was not altered in any of our patients. Union was achieved in all the patients and the mean time to union was 15 weeks. The average knee flexion achieved at the final follow up was 91.7 degrees. Full extension was achieved in 17 of our patients. We had the following complications, loss of reduction (n=1); infection (n=1), post operative DVT (n=1), knee stiffness (n=1) and reactive synovitis (n=1). The average knee society score was 153 and 75 % of our patients had good to excellent results. CONCLUSION: From our study, we conclude that the Minimally Invasive Plate Osteosynthesis (MIPO) technique using Locking Compression Plate (LCP) will results in early post- operative rehabilitation, satisfactory union and good functional outcome. The chances of infection and implant failure are less. Proper patient selection and meticulous surgical techniques will give the best results.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Distal femur fractures ; minimally invasive ; indirect reduction techniques ; MIPO ; knee society score ; locking compression plate.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 19:29
Last Modified: 16 Sep 2017 19:29
URI: http://repository-tnmgrmu.ac.in/id/eprint/2997

Actions (login required)

View Item View Item