Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate

PURPOSE: To report the clinical outcome of polyaxial locking plate (Noncontact bridging (NCB) plate (Zimmer, Warsaw, Indiana)) for the treatment of distal femur fracture with minimal invasive percutaneous periosteal osteosynthsis (MIPPO) technique. MATERIALS AND METHODS: Between February 2008 to April 2010, twenty six patients (11 men, 15 women), twenty eight cases diagnosed as distal femoral fractures are enrolled in this retrospective study. The mean age of the patients was 63 years (34 to 85) and the mean follow-up was 20.3 months (12 to 32). According to the AO/ASIF classification, 15 fractures were type A, 1 type B and 9 type C. And there were 3 periprsthetic fractures around knee. The analysis of the clinical and radiologic outcome were performed by Sanders functional evaluation scale and radiologic follow up after operation, respectively. RESULTS: Among 28 cases, 25 cases united without additional operation. According to Sanders functional evaluation scale, there were 11 excellent, 9 good, 4 fair, 2 poor. As complications, there were 1 knee stiffness, 1 delayed union, 1 implant failure with refracture, 1 implant loosening. Three patients except one knee stiffness, underwent a second LISS plating using NCB plate and and bone grafting, resulting in a satisfactory final outcome. CONCLUSION: Internal fixation using polyaxial locking plate with MIPO technique may be one of the most effective methods for the treatment of distal femoral fractures.

Leg Length Discrepancy Associated with Idiopathic Hemihypertrophy / 대한정형외과학회잡지

PURPOSE: To evaluate the changes in the leg length discrepancy in idiopathic hemihypertrophy as a function of time. MATERIALS AND METHODS: A lower extremity scannogram was performed on 33 patients (16 boys and 17 girls) who were clinically diagnosed with idiopathic hemihypertrophy from September, 1985 to December, 1996. The leg length discrepancy was compared every 6 months. The mean age of the patients on the first visit was 1.6 years (range, 1 to 5 years) and the average follow up period was 9.1 years (range, 8 to 15 years). RESULTS: Not all the discrepancies continued to increase at a constant rate with time. The developmental discrepancy patterns identified were classified as follows: type I, increasing pattern; type II, increasing-plateau pattern; type III, plateau pattern; type IV, increasing-decreasing pattern; type V, decreasing pattern. Twenty five patients (75%) had types I and II discrepancy patterns. CONCLUSION: A continual periodic follow up of the leg length is important in idiopathic hemihypertrophy patients because the developmental patterns of a discrepancy in the length of a lower extremity can vary.