Functional and Radiological Outcomes of Distal Femur Fractures treated with Less Invasive Stabilization System versus Dynamic Condylar Screw

Abstract

Introduction: Fractures in the distal femur are quite rare, comprising around 0.4% of all fractures and 3% of femoral fractures. Managing distal femur fractures has been a subject of debate, but recent developments favor indirect reduction and minimally invasive approaches. The objective is to find a harmonious equilibrium between the mechanical stability of the fractured segments and their biological viability. Given their elevated complication rate, achieving optimal restoration of functional anatomy and ensuring stable fixation is imperative for prompt recovery from distal femoral fractures. Comparison of less invasive stabilization system versus dynamic condylar screw fixation in treatment of distal femur fractures is subject of ongoing debate as to which one is better.

Aims and Objectives: To compare the functional and radiological outcomes of distal femur fractures treated with less invasive stabilization system versus dynamic condylar screw fixation.

Place and Duration of study: A randomized clinical trial was conducted in the Orthopedic Department of Sheikh Zayed Hospital, Lahore, from July 2, 2020, to January 1, 2021.

Material and Methods: A randomized clinical trial was conducted at Sheikh Zayed Hospital in Lahore over a six-month duration. In total 104 patients who fulfilled the inclusion criteria were admitted to the Orthopedic Department via Emergency and OPD. Demographic data and medical histories were taken. The sample size consisted of 52 patients in each group, with random allocation to either the LISS (A) or DCS (B) groups determined by a lottery method. Follow-up appointments were scheduled for all patients at one month, three months, and six months post-surgery. Radiological outcome was evaluated at each follow-up visit while functional outcome assessed at sixth monthly follow up. Data analysis was performed using the SPSS: version 22, considering p ? 0.05 as significant.

Results: Frequency of functional outcome was i.e. excellent (32.7%), good (14.4%), fair (2.9%) in group A and excellent (27.9%), good (31.7%), fair (7.7%) in group B (p-value>0.05). Mean fusion time was 18.67±3.04 in group A and 19.62±4.36 in group B (p-value>0.05).

Conclusion: Our findings indicate no substantial distinction between the two groups. Using DCS or LISS, both methods yield favorable outcomes with negligible complications in the management of distal femoral fractures. Both systems effectively reduce soft tissue injury.