Extra Articular Supracondylar Femur Fractures Managed with Locked Distal Femoral Plate or Supracondylar Nailing: A Comparative Outcome Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 5
Abstract
Introduction: Despite recent evolution in the operating techniques and surgical implants, debate continues around the choice of implant for management of distal femur fractures. High rates of complications and union difficulties continues to make them a momentous therapeutic challenge. Aim: To compare the outcome of locked compressive plating versus retrograde nailing in the management of extra articular supracondylar femur fractures. Materials and Methods: In this randomized prospective study, 42 patients with extra-articular distal femur fractures were segregated into two groups based on internal fixation with distal femoral locking plate (n=22) and retrograde nail (n=20). Clinical and radiological parameters were studied and functional evaluation was done at 18 months with KSS score. Results: A significant difference in terms of mean duration of surgery and intraoperative blood loss was discerned in favour of plating group although complication rates were equivalent between the groups. Mean duration until union was 26.5 weeks (SD=12.9; range 12 to 64 weeks) in the locked plating and 22.6 weeks (SD=13.1: range 12 to 60 weeks) in the retrograde nail group. The difference came out to be statistically insignificant. Fractures in nailed patients united earlier but the difference was not statistically significant with similar overall union rates. Functional scores too were comparable between them. We deduce that surgical planning and expertise rather than the choice of implant are more crucial for optimal results. Conclusion: Nailing proved more cumbersome intraoperatively due to escalated operating time and blood loss and successive anterior knee pain necessitating implant removal but this detriment may be offset by an inclination towards earlier union. With Less Invasive Stabilization System (LISS), technical errors are more common and less forgiving and must be overcome with proper preoperative planning and intraoperative attention to detail.
Authors and Affiliations
SPS Gill, Ankit Mittal, Manish Raj, Pulkesh Singh, Jasveer Singh, Santosh Kumar
Keywords
Related Articles
- EP ID EP343513
- DOI 10.7860/JCDR/2017/25062.9936
- Views 80
- Downloads 0
Are Automated Blood Pressure Apparatus Reliable? Automated Versus Manual Measurement of Blood Pressure
ABSTRACT Introduction: With hypertension becoming a global burden, it is necessary to validate the Blood Pressure (BP) recordings, used to screen and follow-up patients for hypertension. Since three different devices (me...
Role of Papanicolaou Smear in the Diagnosis of Pathologic Flora in Asymptomatic Patients in Rural Health Care Set-Up
Introduction: The infections of female genital tract, especially the cervix are asymptomatic in presentation and pose a diagnostic challenge. Vaginal infections can lead to cytoplasmic and nuclear abnormalities in the ep...
Groin Flap in Paediatric Age Group to Salvage Hand after Electric Contact Burn: Challenges and Experience
Introduction: Electric contact burn is characterised by multiple wounds produced by entrance and exit of the current. Hand is most commonly involved in the same and children are particularly susceptible to such accidents...
Factor Structure of Schizotypal Personality in India
ABSTRACT Introduction: Schizotypal personality represents genetic underpinning of schizophrenia spectrum disorders; hence, it provides conceptual models for understanding psychosis as well as a scheme for high-risk group...
Prevalence of blaCTX-M, blaCTX-M-2, blaCTX-M-8, blaCTX-M-25 and blaCTX-M-3 Genes in Escherichia coli Isolated from Urinary Tract Infection in Kermanshah City, Iran
ABSTRACT Introduction: Urinary Tract Infection (UTI) is one of the most common bacterial infections and Escherichia coli is the most common organism that causes UTI. However, the incidence of community acquired UTI cause...