Surgical Treatment of AO/OTA 33-C Intra-Articular Distal Femoral Fractures through Parapatellar Approach

ABSTRACT

Purpose@#To report the surgical results of the parapatellar approach for AO/OTA 33-C distal femoral intra-articular fractures. @*Materials and Methods@#Twenty-one patients with AO/OTA 33-C distal femoral intra-articular fracture were included. There were 11 cases of C2 and 10 cases of C3 fractures. The time of union and the coronal alignment were radiographically investigated. The complications related to surgery were clinically investigated, and a functional evaluation using the range of motion and Oxford knee score was performed to compare the surgical results according to fracture classification. @*Results@#In all cases, sufficient articular exposure and anatomical reduction were achieved with the parapatellar approach. No cases of coronal malalignment, loss of reduction, and plate failure were noted. On the other hand, in four cases (19.0%), an autogenous bone graft was performed due to delayed union on the meta-diaphyseal fracture site. There were no differences in the radiological and clinical outcomes of the C2 and C3 fractures. The knee joint pain and Oxford knee score were poorer in the delayed union group than the normal union group. @*Conclusion@#The parapatellar approach is useful for achieving an anatomical reduction of the articular surface of the distal femur and minimally invasive plating technique. Although satisfactory surgical results could be obtained regardless of the degree of articular comminution, a study of the risk factors of delayed metaphyseal fusion may be necessary.