Distal Femur Extraarticular fracture, simple

Open reduction internal fixation (ORIF); angled blade plate

ORIF - blade plate

Indication summary: Indirect reduction not possible, image intensification not available, Surgeon's preference

Skill: Highly experienced and skilled surgeon
Equipment: Full specialized surgical and imaging resources

The advantage of a blade plate, when inserted in an open manner, is that the surgeon can use the implant as a reduction aid. By inserting the blade plate, in the correct position in the distal femoral block, the surgeon ensures appropriate varus/valgus reduction when the plate is brought down to the bone.

Indications

  • Closed and open fractures
  • Closed reduction impossible
  • Image intensifier not available
  • Early pregnancy (up to 12 weeks gestation; reduces intraoperative radiation)

Contraindications

  • Polytrauma patient in highly unstable condition
  • Patient not medically fit for surgery – revert to nonoperative treatment
  • Local soft-tissue pathology

Advantages

  • Definitive procedure
  • Less exposure to ionizing radiation
  • Direct reduction
  • Fracture stabilization allows for early patient mobilization
  • Can be used in cases of pulmonary compromise

Disadvantages

  • Risk of malrotation
  • Risk of varus and/or valgus malposition
  • Risk of infection
  • Risk of greater blood loss
  • Exposure of fracture zone / interference with biology of healing
  • Larger operative soft-tissue trauma
  • More visible scarring
  • Technically demanding procedure

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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v1.0 2008-12-03