A surgical management of AO type 33c distal femur fractures using VA-LCP

Abstract

Back Ground: Fractures of Distal Femur are common due to increased Road traffic accidents and fall from height because of increased construction activities. These fractures are quite disabling. So these fractures necessitate early stabilization. Internal fixation with VA-LCP has shown to give one of the best results in terms of fixation, recovery, fracture union and clinical outcome. Materials and Methods: 23 cases of Distal femur fractures treated with VA-LCP from August 2016 to August 2018 were selected for this study. They were admitted and examined according to protocol clinically and radiologically. All patients were followed up for a minimum of 6 months and outcome assessed with Neer’s score. Results: All fractures healed with an average duration of 23 weeks which is comparable with other studies. We had excellent outcome in 6 (26%) patient, satisfactory outcome in 13 (57%) patient and 4 had an unsatisfactory (17%) result. Average Neer’s Knee score was 81 which is comparable with other studies. Conclusion: The VA-LCP is the treatment of choice in the management of comminuted distal femoral fractures especially Type C fractures, where type C1 we have found higher Neer’s scores. VA-LCP also prevents compression of periosteal vessels. VA- LCP is the implant of choice especially in type C3 fractures as we can get purchase of multiple fracture fragments avoiding intra articular screw penetration because of screw insertion angle upto 150 compared to fixed orthogonal screw placement. Although in our series poor result were found in type C3 fractures we attribute this to long learning curve in treatment of type C3 fractures.

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