Keyur Patel*

Orthopaedic Surgeon, Gujarat, India

*Corresponding Author: Keyur Patel, Orthopaedic Surgeon, Gujarat, India.

Received: January 22, 2024; Published: February 26, 2024

Abstract

Purpose: To report functional and radiological outcomes of using lateral plate and debridement in stage 1 followed by fibular strut graft together with cancellous graft and medial plating in second stage after 3-4 weeks in distal femoral fractures. In 5 cases, 3 were operated in staged manner and 2 cases with single stage bone grafting and platting amongst which one case (33-A3) with vascular injury operated with single lateral plate and fibula and cancellous graft in second stage.

Method: A retrospective study on 5 patients with comminuted distal femoral open grade fractures managed single/dual stage single/dual plate and fibula and cancellous grafting by Swashbuckler approach has been conducted. Only distal femoral fractures type 33-A3, 33-C2, and 33-C3, were included. The patient’s mean age was 25.2 years. Evaluation included operative time, blood loss, time to union, knee range of motion, Sanders scoring, and presence of complications.

Results: All patients had no postoperative knee stiffness with a range of motion (90-120°) during follow-up. The time for radiological union was at 3 months, with no cases of non-union. The average follow-up period was 3 to 4 months and 6month and yearly follow up are yet to come. Mean intraoperative blood loss was 325 ml, and mean operative time was 76.87 min without anaesthesia. All patients had a knee range of motion (90–120°) during follow-up. Time for union at 3 months, with no cases of non-union. A total of 5 patients 3 (60%) showed excellent functional outcomes, and the remaining 2 (40%) showed good functional outcomes according to the Sanders scoring system. Only one cases had late infections (1yr post op) managed by implant removal after 1 year. No post-operative deformity, loss of reduction, or implant failure was observed until the end of follow-up period

Conclusion: Staged debridement with single plate f/b 2nd fibular grafting and medial plate in more contaminated and single staged procedure in non-contaminated cases BG and dual plating of comminuted distal femur fractures in patients is an effective technique with higher rates of union and lower re-operation rates compared to other fixation modalities.

Keywords: Open Distal Femur Fractures; Fibula; Cancellous Graft

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Citation

Citation: Keyur Patel. “Management of Complex Open Distal Femur Fractures with Fibula and Cancellous Graft: Case Series".Acta Scientific Orthopaedics 7.3 (2024): 88-93.

Copyright

Copyright: © 2024 Keyur Patel. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.