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Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Comparison of supraintercondylar and supracondylar femur fractures treated with condylar buttress plates

Authors: Chun-Jui Weng, Chi-Chuan Wu, Kuo-Fun Feng, I-Chuan Tseng, Po-Cheng Lee, Yu-Chih Huang

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

Treatment of supraintercondylar (AO/OTA 33-C) and supracondylar (AO/OTA 33-A) femur fractures is generally challenging. Standard treatments include open reduction and internal fixation. However, optimal implants are now being well-defined. This study focus on the comparison between clinical and functional outcomes of fractures treated with condylar buttress plates (CBPs).

Methods

We treated 87 patients with supraintercondylar or supracondylar femur fracture from 2004 to 2008, including 30 supraintercondylar and 24 supracondylar fractures treated with CBPs. Both knee and function scores (per Knee Society) were given to clinical and functional outcomes, and concomitant knee function was assessed per Mize criteria.

Results

Union rate of supraintercondylar fractures was 90 % (27/30) and supracondylar fractures was 91.7 % (22/24) (P = 0.68). In supraintercondylar group, 16.7 % revealed postoperative varus deformity, whereas none in supracondylar group (P = 0.045). Knee Society knee score was 73.6 in supraintercondylar group and 85.5 in supracondylar group (P = 0.009); and function score was 62.5 in supraintercondylar group and 83.1 in supracondylar group (P = 0.023). A satisfactory result based on modified Mize criteria was achieved in 50 % of supraintercondylar fractures and in 79.1 % of supracondylar fractures (P = 0.09).

Conclusions

Use of CBPs for supraintercondylar and supracondylar femur fractures treatment led to a high union rate. However, a high rate of varus deformity occurred in patients with supraintercondylar but not supracondylar fractures. Moreover, CBP treatment in patients with supracondylar fractures led to better functional outcomes than those with supraintercondylar fractures.
Literature
1.
go back to reference Stewart MJ, Sisk D, Wallae SL. Fractures of the distal third of the femur. A comparison of methods of treatment. J Bone Joint Surg Am. 1966;48:95–104. Stewart MJ, Sisk D, Wallae SL. Fractures of the distal third of the femur. A comparison of methods of treatment. J Bone Joint Surg Am. 1966;48:95–104.
2.
go back to reference Neer 2nd CS, Grantham SA, Shelton ML. Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Joint Surg Am. 1967;49(4):591–613.PubMed Neer 2nd CS, Grantham SA, Shelton ML. Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Joint Surg Am. 1967;49(4):591–613.PubMed
3.
go back to reference Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979;138:77–83.PubMed Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979;138:77–83.PubMed
4.
go back to reference Giles JB, DeLee JC, Heckman JD, Keever JE. Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. J Bone Joint Surg Am. 1982;64(6):864–70.PubMed Giles JB, DeLee JC, Heckman JD, Keever JE. Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. J Bone Joint Surg Am. 1982;64(6):864–70.PubMed
5.
go back to reference Mize RD, Bucholz RW, Grogan DP. Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am. 1982;64(6):871–9.PubMed Mize RD, Bucholz RW, Grogan DP. Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am. 1982;64(6):871–9.PubMed
6.
go back to reference Mize RD. Surgical management of complex fractures of the distal femur. Clin Orthop Relat Res. 1989;240:77–86.PubMed Mize RD. Surgical management of complex fractures of the distal femur. Clin Orthop Relat Res. 1989;240:77–86.PubMed
7.
go back to reference Sanders R, Regazzoni P, Ruedi TP. Treatment of supracondylar-intracondylar fractures of the femur using the dynamic condylar screw. J Orthop Trauma. 1989;3(3):214–22.CrossRefPubMed Sanders R, Regazzoni P, Ruedi TP. Treatment of supracondylar-intracondylar fractures of the femur using the dynamic condylar screw. J Orthop Trauma. 1989;3(3):214–22.CrossRefPubMed
8.
go back to reference Sanders R, Swiontkowski M, Rosen H, Helfet D. Double-plating of comminuted, unstable fractures of the distal part of the femur. J Bone Joint Surg Am. 1991;73(3):341–6.PubMed Sanders R, Swiontkowski M, Rosen H, Helfet D. Double-plating of comminuted, unstable fractures of the distal part of the femur. J Bone Joint Surg Am. 1991;73(3):341–6.PubMed
10.
go back to reference Petsatodis G, Chatzisymeon A, Antonarakos P, Givissis P, Papadopoulos P, Christodoulou A. Condylar buttress plate versus fixed angle condylar blade plate versus dynamic condylar screw for supracondylar intra-articular distal femoral fractures. J Orthop Surg (Hong Kong). 2010;18(1):35–8. Petsatodis G, Chatzisymeon A, Antonarakos P, Givissis P, Papadopoulos P, Christodoulou A. Condylar buttress plate versus fixed angle condylar blade plate versus dynamic condylar screw for supracondylar intra-articular distal femoral fractures. J Orthop Surg (Hong Kong). 2010;18(1):35–8.
12.
go back to reference Weng CJ, Wu CC, Feng KF, Tseng IC, Lee PC, Huang YC. High incidence of varus deformity in association with condylar buttress plates used to treat supraintercondylar fracture of the femur. Formosan J Musculoskelet Disord. 2012;3:50–5.CrossRef Weng CJ, Wu CC, Feng KF, Tseng IC, Lee PC, Huang YC. High incidence of varus deformity in association with condylar buttress plates used to treat supraintercondylar fracture of the femur. Formosan J Musculoskelet Disord. 2012;3:50–5.CrossRef
13.
go back to reference Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1–133.CrossRefPubMed Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1–133.CrossRefPubMed
14.
go back to reference Keats TE, Teeslink R, Diamond AE, Williams JH. Normal axial relationships of the major joints. Radiology. 1966;87(5):904–7.CrossRefPubMed Keats TE, Teeslink R, Diamond AE, Williams JH. Normal axial relationships of the major joints. Radiology. 1966;87(5):904–7.CrossRefPubMed
15.
go back to reference Bucholz RW, Heckman JD, Court-Brown CM, Tornetta III P. Rockwood and Green's Fractures in Adults. 7 ed. 2009. Bucholz RW, Heckman JD, Court-Brown CM, Tornetta III P. Rockwood and Green's Fractures in Adults. 7 ed. 2009.
16.
go back to reference Andriacchi TP. Dynamics of knee malalignment. Orthop Clin North Am. 1994;25(3):395–403.PubMed Andriacchi TP. Dynamics of knee malalignment. Orthop Clin North Am. 1994;25(3):395–403.PubMed
17.
go back to reference Zhao D, Banks SA, Mitchell KH, D'Lima DD, Colwell Jr CW, Fregly BJ. Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res. 2007;25(6):789–97. doi:10.1002/jor.20379.CrossRefPubMed Zhao D, Banks SA, Mitchell KH, D'Lima DD, Colwell Jr CW, Fregly BJ. Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res. 2007;25(6):789–97. doi:10.​1002/​jor.​20379.CrossRefPubMed
18.
go back to reference Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–4.PubMed Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–4.PubMed
20.
go back to reference Heiney JP, Barnett MD, Vrabec GA, Schoenfeld AJ, Baji A, Njus GO. Distal femoral fixation: a biomechanical comparison of trigen retrograde intramedullary (i.m.) nail, dynamic condylar screw (DCS), and locking compression plate (LCP) condylar plate. J Trauma. 2009;66(2):443–9. doi:10.1097/TA.0b013e31815edeb8.CrossRefPubMed Heiney JP, Barnett MD, Vrabec GA, Schoenfeld AJ, Baji A, Njus GO. Distal femoral fixation: a biomechanical comparison of trigen retrograde intramedullary (i.m.) nail, dynamic condylar screw (DCS), and locking compression plate (LCP) condylar plate. J Trauma. 2009;66(2):443–9. doi:10.​1097/​TA.​0b013e31815edeb8​.CrossRefPubMed
21.
go back to reference Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ. Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005). J Orthop Trauma. 2006;20(5):366–71.CrossRefPubMed Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ. Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005). J Orthop Trauma. 2006;20(5):366–71.CrossRefPubMed
22.
go back to reference Herrera DA, Kregor PJ, Cole PA, Levy BA, Jonsson A, Zlowodzki M. Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981-2006). Acta Orthop. 2008;79(1):22–7. doi:10.1080/17453670710014716.CrossRefPubMed Herrera DA, Kregor PJ, Cole PA, Levy BA, Jonsson A, Zlowodzki M. Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981-2006). Acta Orthop. 2008;79(1):22–7. doi:10.​1080/​1745367071001471​6.CrossRefPubMed
23.
go back to reference Davison BL. Varus collapse of comminuted distal femur fractures after open reduction and internal fixation with a lateral condylar buttress plate. Am J Orthop (Belle Mead NJ). 2003;32(1):27–30. Davison BL. Varus collapse of comminuted distal femur fractures after open reduction and internal fixation with a lateral condylar buttress plate. Am J Orthop (Belle Mead NJ). 2003;32(1):27–30.
24.
go back to reference Dar GN, Tak SR, Kangoo KA, Halwai MA. Bridge plate osteosynthesis using dynamic condylar screw (DCS) or retrograde intramedullary supracondylar nail (RIMSN) in the treatment of distal femoral fractures: comparison of two methods in a prospective randomized study. Ulus Travma Acil Cerrahi Derg. 2009;15(2):148–53.PubMed Dar GN, Tak SR, Kangoo KA, Halwai MA. Bridge plate osteosynthesis using dynamic condylar screw (DCS) or retrograde intramedullary supracondylar nail (RIMSN) in the treatment of distal femoral fractures: comparison of two methods in a prospective randomized study. Ulus Travma Acil Cerrahi Derg. 2009;15(2):148–53.PubMed
25.
go back to reference Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Intra-articular fractures of the distal femur: a long-term follow-up study of surgically treated patients. J Orthop Trauma. 2004;18(4):213–9.CrossRefPubMed Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Intra-articular fractures of the distal femur: a long-term follow-up study of surgically treated patients. J Orthop Trauma. 2004;18(4):213–9.CrossRefPubMed
Metadata
Title
Comparison of supraintercondylar and supracondylar femur fractures treated with condylar buttress plates
Authors
Chun-Jui Weng
Chi-Chuan Wu
Kuo-Fun Feng
I-Chuan Tseng
Po-Cheng Lee
Yu-Chih Huang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1278-2

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