FUNCTIONAL OUTCOME IN PATIENTS WITH DISTAL FEMUR FRACTURE TREATED WITH LOCKING COMPRESSION PLATE
DOI:
https://doi.org/10.71000/phn18419Keywords:
Bone Plates, Femoral Fractures, Fracture Fixation Internal, Knee Injuries, Locking Compression Plate, Orthopedic Procedures, Postoperative RecoveryAbstract
Background: Distal femur fractures pose significant treatment challenges due to their anatomical complexity and varied injury mechanisms. Locking compression plates (LCPs) have emerged as a favorable fixation method, particularly for complex and osteoporotic fractures. Despite global advancements, limited local data exist on the functional outcomes following LCP fixation in the regional population.
Objective: To determine the functional outcome in patients with distal femur fractures treated with locking compression plates using Neer’s scoring system.
Methods: This descriptive study was conducted over six months at the Department of Orthopedics, Khyber Teaching Hospital, Peshawar. A total of 152 patients aged 18–60 years with AO type A or C distal femur fractures were included. Exclusion criteria were open wounds, pathological fractures, peri-prosthetic fractures, delayed presentations, and significant comorbidities. Surgical fixation was performed using the Swashbuckler approach, followed by individualized rehabilitation protocols. Functional outcomes were assessed four weeks postoperatively using Neer’s criteria. Data were analyzed using SPSS version 25.
Results: Among 152 patients, the mean age was 38.6 ± 11.5 years; 63.8% were male. Right-sided fractures were more common (56.6%). Type A fractures slightly outnumbered type C (50.7% vs. 49.3%). Neer’s score showed excellent outcomes in 55.9% of cases, good in 29.6%, fair in 13.2%, and poor in 1.3%. Type A fractures showed superior results compared to type C. No major intraoperative complications were reported.
Conclusion: LCP fixation for distal femur fractures yields promising early functional outcomes, particularly in type A fractures. It supports early mobilization, anatomical alignment, and satisfactory recovery, reinforcing its role as a preferred surgical modality in such injuries.
References
Passias BJ, Emmer TC, Sullivan BD, Gupta A, Myers D, Skura BW, et al. Treatment of Distal Femur Fractures with a Combined Nail-Plate Construct: Techniques and Outcomes. J Long Term Eff Med Implants. 2021;31(3):15-26.
Kubik JF, Bornes TD, Gausden EB, Klinger CE, Wellman DS, Helfet DL. Surgical outcomes of dual-plate fixation for periprosthetic femur fractures around a stable hip arthroplasty stem. Arch Orthop Trauma Surg. 2022;142(12):3605-11.
Zhang JH, Liu H, Cai TY, Lin YZ, Wu J. Resistant distal femoral nonunion treated with combined nail/plate construct and reamer-irrigator-aspirator technique. J Int Med Res. 2023;51(7):3000605231187945.
Tsegaye YA, Tegegne BB, Ayehu GW, Amisalu BT, Sulala AC. Prospective study on functional outcome of distal femur fracture treated by open reduction and internal fixation using distal femur locking plate in Tibebe Ghion Specialized Hospital, Bahirdar, North West Ethiopia. J Orthop Surg Res. 2024;19(1):582.
Yenigül AE, Ermutlu C, Önder C, Atıcı T, Durak K. Outcomes of cable fixation after Vancouver type B1 periprosthetic femoral fractures. Ulus Travma Acil Cerrahi Derg. 2023;29(11):1314-9.
Völk D, Neumaier M, Einhellig H, Biberthaler P, Hanschen M. Outcome after polyaxial locking plate osteosynthesis in proximal tibia fractures: a prospective clinical trial. BMC Musculoskelet Disord. 2021;22(1):286.
Shi BY, Brodke DJ, O'Hara N, Devana S, Hernandez A, Burke C, et al. Nail Plate Combination Fixation Versus Lateral Locked Plating for Distal Femur Fractures: A Multicenter Experience. J Orthop Trauma. 2023;37(11):562-7.
Meccariello L, Bisaccia M, Ronga M, Falzarano G, Caraffa A, Rinonapoli G, et al. Locking retrograde nail, non-locking retrograde nail and plate fixation in the treatment of distal third femoral shaft fractures: radiographic, bone densitometry and clinical outcomes. J Orthop Traumatol. 2021;22(1):33.
Müller F, Füchtmeier B, Zellner M, Bäuml C, Wulbrand C. Locking plate for periprosthetic femoral fractures according to Vancouver C: Outcome and radiological subanalysis of 40 patients. Eur J Orthop Surg Traumatol. 2024;34(1):119-26.
Gassner C, Sommer F, Rubenbauer B, Keppler AM, Liesaus Y, Prall WC, et al. [Locking plate fixation of distal periprosthetic femoral fractures : Clinical outcome and mortality]. Unfallchirurg. 2021;124(6):473-80.
Li Z, Chen Z, Wang X, Li J, Jing L, Li Z, et al. Locking Plate Alone or in Combination with Cannulated Screws for Hoffa Fractures: A Retrospective Study. Orthop Surg. 2022;14(3):492-500.
Fan S, Yin M, Xu Y, Ren C, Ma T, Lu Y, et al. Locking compression plate fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity: a retrospective study. J Orthop Surg Res. 2021;16(1):285.
Xu K, Wang G, Lu L, Ding C, Ding Y, Chang X, et al. Intramedullary nail fixation assisted by locking plate for complex subtrochanteric femur fractures: A retrospective study. J Orthop Sci. 2023;28(5):1105-12.
Sonaullah M, Islam MS, Ali MA, Rahman MMM, Afsar MN, Shakil MIH, et al. Functional Outcome of Subtrochanteric Femoral Fractures Fixation by Proximal Femoral Locking Compression Plate. Mymensingh Med J. 2025;34(1):21-30.
Landes EK, Konda SR, Leucht P, Ganta A, Egol KA. Fixed-angle plate fixation and autogenous iliac crest graft for repair of distal metaphyseal femoral nonunion. Eur J Orthop Surg Traumatol. 2023;33(5):1835-9.
Oransky M, Galante C, Cattaneo S, Milano G, Motta M, Biancardi E, et al. Endosteal plating for the treatment of malunions and nonunions of distal femur fractures. Eur J Orthop Surg Traumatol. 2023;33(6):2243-51.
Andring NA, Kaupp SM, Henry KA, Helmig KC, Babcock S, Halvorson JJ, et al. Dual Plate Fixation of Periprosthetic Distal Femur Fractures. J Orthop Trauma. 2024;38(1):36-41.
Von Rehlingen-Prinz F, Eggeling L, Dehoust J, Huppke C, Strahl A, Neumann-Langen MV, et al. Current standard of care for distal femur fractures in Germany and Switzerland. Injury. 2023;54(10):110936.
Vialla T, Tran-Minh D, Barbotte F, Herault A, Ehlinger M, Ohl X, et al. Comparison of the functional outcomes after treatment of periprosthetic hip fractures with femoral stem loosening: Locking plate fixation with or without femoral stem revision. Orthop Traumatol Surg Res. 2022;108(6):103300.
Li Z, Li J, Li Z, Nie S, Zhang H, Li M, et al. Comparative study of anatomical locking plate and reconstruction plate in treating acetabular fractures. Int Orthop. 2021;45(10):2727-34.
Kaufman MW, Rascoe AS, Hii JL, Thom ML, Levine AD, Wilber RG, et al. Comparable Outcomes Between Native and Periprosthetic Fractures of the Distal Femur. J Knee Surg. 2023;36(11):1111-5.
Pfister B, Wilson A, Drobetz H. Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail-Plate Construct. Orthop Surg. 2023;15(12):3326-34.
Stadnyk M, Gibbon S, Buckley R. Are dual, lateral and medial plates, better than a single lateral locking plate for osteoporotic intra-articular distal femur fractures? Injury. 2024;55(7):111592.
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Copyright (c) 2025 Muhammad Maaz Raza, Awal Hakeem , Muhammad Tufail, Syed Zeeshan Hassan Arif , Waqar Ali , Ubaid Ullah (Author)

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