Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution / 대한정형외과학회잡지

ABSTRACT

PURPOSE: We wanted to report on the functional results and the presence of axial malalignment after performing minimally invasive plate osteosynthesis in distal femur fractures with metaphyseal comminution. MATERIALS AND METHODS: Between March 2007 and June 2009, fifteen patients with distal femur fractures and metaphyseal comminution were treated with minimally invasive plate osteosynthesis, and they were followed for a mean of 17.0 months (range 12-40 months). The fractures according to the AO/OTA classification were two cases of 33A and thirteen cases of 33C, and seven cases were open fracture. We analyzed the axial malalignment and functional results according to bone union and Sanders' score. RESULTS: All the fractures were united without a bone graft after a mean of 20.4 weeks (range 16-26 weeks) after the definitive plate fixation. One case had superficial infection and a stiff knee. The average ROM of the knee was 123.6degrees. The average Sanders' score was 33.0, and the results were five cases of excellent results, eight cases of good results and two cases of fair results. There was axial malalignment such as varus malunion in 3 cases and valgus malunion in 2 cases and the average shortening of the limb length was 7.9 mm (range 0.3-21.9 mm). CONCLUSION: Minimally invasive plate osteosynthesis in a distal femur fracture with metaphyseal comminution provides satisfactory outcomes. However, this should be approached with caution because of the possibility of axial malalignment.