Fixation of distal femoral fractures: Restoration of the knee motion.

BACKGROUND Most of healed lower femoral fractures resulted in various degree of loss of the knee motion. Flexion deficit is a serious problem for the Eastern persons that are where squatting and sitting on the ground are necessary for daily activities. The aims of this study were to compare outcomes of using condylar buttress plate and dynamic condylar screw (DCS) in treatment of distal femoral fractures. Secondly, we present our clinical experience for optimizing the technical application of the studied implants. METHODS Two groups (plate and DCS) of 57 patients were treated for 59 lower femoral fractures with condylar buttress plate or DCS and followed prospectively for 24 months. RESULTS Plate group reported adequate reduction in 67% and varus angulation in 13.3% of the fractures. DCS group reported adequate reduction in 72.4% and posterior angulations in 17% of the fractures. Other reasons for inadequacy of reduction were reported in both groups. Full knee motion range was achieved in 50% of plate group and in 55% of DCS group. 75% and 90% satisfactory functional outcomes were reported in the plate and DCS groups respectively. CONCLUSION Both implants nearly achieved equal results concerning restoration of knee motion range. The condylar buttress plate and DCS are liable for technical optimization.