A Prospective Study to evaluate the functional outcome of open and closed reduction for distal end femur fractures

Abstract

Background: Supra-condylar and inter-condylar fractures of the distal femur historically have been difficult to treat. They account for 7% of all femoral fractures. Because of the proximity of these fractures to the knee joint, regaining full knee motion and function may be difficult. Aim: To study the functional outcome of open reduction and locking plate fixation for fractures of distal end of femur. Methods: A total of 25 patients were enrolled for this prospective study and all were treated with locking compression plate. Physical examination and radiographs were performed at regular follow-ups. Functional outcomes were analyzed using Modified Hospital for Special Surgery scoring system. Results: Patients were followed up every 2 weeks in the first month, then monthly for 3 months and then once every 3 months. The average range of knee flexion achieved was about 101°. The average knee score was 88.88 rated using Modified Hospital for Special Surgery functional score. The difference in knee range of motion was statistically significant for closed and open fractures but knee score and age was not statistically significant. Intra-articular fractures tend to have poorer results with respect to pain and function, more so because of the nature of the injury rather than the implant used, which limits the movement and causes loss of strength more than instability. Conclusion: Closed fractures have a higher range of motion as well as a better knee score as compared to open fractures thereby showing that soft tissue compromise also affects range of motion and further rehabilitation of the limb.