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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

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Vol 03 | January 2022 | page: 39-43 | Sidheswar Baskey

DOI: https://doi.org/10.13107/ojot.2022.v03i01.032

Authors: Sidheswar Baskey [1]

[1] Department of Orthopaedic Surgery, SCB Medical College and Hospital, Cuttack, Odisha, India.

Address of Correspondence

Dr. Sidheswar Baskey
Department of Orthopaedic Surgery, SCB Medical College and Hospital, Cuttack, Odisha, India.
E-mail: stylishdoc@gmail.com

Abstract

Background: Fractures of distal femur are very complex injuries and there is significant difficulty to manage. These injuries are severe and have a potential to produce long term disability. These fractures often are unstable and comminuted and tend to occur in elderly or multiply-injured patients.

The fractures of distal femur account for 7% of all femoral fractures. If Hip fractures are excluded, 31% of fractures involve the distal femur. The fractures involving distal 15 cm of femur including distal femoral metaphysis (supracondylar) and articular surface (intercondylar) are classified as distal femur fractures [1].

Distal femur fractures exhibits bimodal age distribution. In young adults it occurs due to high velocity trauma like road traffic accidents. These patients often sustain multiple and compound injuries. Older patients sustain distal femur fractures mostly due to trivial fall occurring in elderly osteoporotic bone.

In 1960’s most of these fractures were treated conservatively and documented better outcome than operative treatment. But with the advent of newer implants and modern techniques, these fractures are best treated with surgical stabilization. The newer modalities of treatment include minimally invasive plate osteosynthesis (MIPO) and Less invasive skeletal stabilization (LISS).
Aim of this study: To evaluate twenty cases of distal femur fractures fixed with locking compression plate by minimally invasive plate osteosynthesis (MIPO) technique in the Department of Orthopaedic Surgery at SCB Medical College and Hospital, Odisha between July 2018 to November 2020. To prospectively analyse the clinical and radiological outcome of the above procedure.
Keywords: Minimally Invasive Plate Osteosynthesis (MIPO), Distal Femoral Fractures, Radiological Outcome, Locking Compression Plate

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How to Cite this Article: Baskey S | 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 | Odisha Journal of Orthopaedics and Trauma | January 2022; 03: 39-43. https://doi.org/10.13107/ojot.2022.v03i01.032

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A Retrospective Analysis of Functional and Radiological Outcome of Different Modalities of Treatment of Fracture of Distal Radius

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Vol 03 | January 2022 | page: 05-09 | Soumendra Kumar Majhi

DOI: https://doi.org/10.13107/ojot.2022.v03i01.025

Authors: Soumendra Kumar Majhi [1]

[1] Department of Orthopaedics, Sri Rama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.

Address of Correspondence

Dr. Soumendra Kumar Majhi,
Department of Orthopaedics, Sri Rama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.
E-mail: kmsoumendra@gmail.com

Abstract

Background: Fractures of the distal radius remain the most common fractures approximately one-sixth of all fractures treated in emergency departments. There are three main peaks of fracture distribution: the first peak is in children ages 5 to 14, the second is in males under age 50 and the third peak is in females over the age of 40 years. Risk factors are – decreased bone mineral density, female gender, ethnicity, heredity & early menopause have all been shown to be risk factors for this injury. The outcome of these fractures is not uniformly good regardless the treatment instituted. A thorough understanding of the anatomy & biomechanics of the wrist is a prerequisite when treating these lesions. There is a strict relationship between the quality of anatomical reconstruction & the long-term functional outcome. No single treatment is the solution for every type of fracture in every kind of patient. Based on the functional anatomy, we analyze the actual treatment possibilities & try to develop strategies in the choice of treatment for different fracture types in different patient groups.
Materials and Methods: 92 Patients with extra-articular distal radius fractures were studied retrospectively. 30 were treated with conservative management and 62 with surgical management. Out of 62 cases treated surgically, 11 were managed by Plate osteosynthesis, 27 with Ligamentotaxis with External fixator & 24 with K wire fixation using Kapandji method at Department of Orthopaedics, Sri Rama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, since July 2018 to November 2020.
Results: The association of individuals anatomical parameters with the functional results was measured by Chi-square test of association and Odds ratio with the criteria of Stewart et al. taken as base line for comparison. This study showed a significant association of dorsal angulation < 10° and loss of radial inclination of < 9° with functional results, P < 0.001 also with loss of radial height < 6 mm, P < 0.001 (0.005). On reviewing literature only few articles were found determining values of individual radiological parameters for better functional outcome specially Smilovic et al. (2003) and few of them noted which parameters affect the function most but not determining the values for them.
Conclusion: There was no significant difference in the functional outcome of conservative treatment in comparison to various surgical modalities namely plate osteosynthesis, ligamentotaxis and k wire reduction with Kapandji method in case of extra articular and partial articular fractures of distal radius. Therefore, we cannot generalize one treatment method for all fracture patterns and treatment should be individualized to a particular fracture.
Keywords: Distal radius fracture, Radiological outcome, Functional outcome

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How to Cite this Article: Majhi SK | A Retrospective Analysis of Functional and Radiological Outcome of Different Modalities of Treatment of Fracture of Distal Radius | Odisha Journal of Orthopaedics and Trauma | January 2022; 03: 05-09. https://doi.org/10.13107/ojot.2022.v03i01.025

(Abstract Text HTML)      (Download PDF)