Distal Femur Extraarticular fracture, wedge

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 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 ionizing radiation)

Contraindications

  • Polytrauma patient in highly unstable condition
  • Patient not medically fit for surgery
  • Local soft-tissue compromise

Advantages

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

Disadvantages

  • Risk of infection
  • Risk of greater blood loss
  • Exposure of fracture zone
  • Larger operative soft-tissue trauma
  • More visible scarring

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