Distal Femur Extraarticular fracture, simple

Open reduction internal fixation (ORIF); condylar locking compression plate (LCP)

ORIF - condylar locking compression plate (LCP)

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

The condylar LCP is more expensive than the DCS or the angled blade plate.

Indications

  • Closed and open fractures
  • Closed reduction impossible
  • Some periprosthetic fractures
  • 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
  • Osteomyelitis or 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
  • Less appealing cosmetic result

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