A Prospective Study of Functional Outcome of Locking Compression Plate Fixation Over Dynamic Condylar Screw Fixation in the Treatment of Distal Femur Fractures

Aim: To analyse and compare the functional outcome of distal femur fractures treated with Locking Compression Plate fixation and Dynamic Condylar Screw fixation Materials and Methods: Our study is a prospective study conducted in Department of orthopedics, Government Dharmapuri Medical College and Hospital, Dharmapuri, Tamil Nadu from July 2015 to January 2021. Patients admitted with distal femur fractures are selected on the basis of inclusion and exclusion criteria. We have followed Muller Classification for distal femur fractures, based on which treatment modalities determined. Our study sample size is 25 patients, of which 10 patients were treated with dynamic condylar screw and 15 patients with distal femur locking compression plate. We have used Extensile Lateral approach to fix the fracture with patient supine with sand bag underneath knee. Fractures treated with either LCP and DCS followed in standard protocol and evaluated in serial follow up. Functional outcome analyzed using standard scoring system called Hospital for Special Surgery. Result: In our study Males are more affected with 80% and age group 40 - 50 years more commonly involved with 28%. Mode of injury Road traffic accidents in 76% patients and 24% in accidental fall.11 patients got associated injuries. Muller sub type C2, C3 accounts for 40% of patients. Open injuries of type I and II accounts for 20% of all fractures. Distal femur fractures treated with DCS shows 60% excellent and good outcome and 40% shows fair and poor outcome, whereas those treated with LCP shows 66.6% excellent and good results and 33.3% fair and poor results. Overall in our study 64% excellent and good outcome and 36% poor outcome. Muller subtype - A fractures with both LCP and DCS showed similar results whereas for Muller subtype C, LCP showed very good results when compared to DCS.5 Patients shown complications like superficial wound infection, deep infection. Conclusion: Fractures of distal femur are more common in high velocity injuries and occur in middle aged men and old age women. Most fractures were comminuted. Locking compression plate [LCP] appears to be technically an ideal implant for comminuted distal femoral fractures with proper physiotherapy produced excellent results, whereas extra articular distal femoral fracture with Type A fractures LCP and DCS shown similar results. However large study group and long follow up needed for accurate functional outcome.