EC Orthopaedics

Introduction: The fractures which are usually located at the distal part of the femur can be supracondylar or intercondylar. Such fractures have been very hard to deal with since they have an unstable nature and possess a big challenge when it comes to defining their degree of comminution.

Nowadays with newer techniques and special materials, the results of surgical treatment are good, even in older patients who have poor bone quality. In our study, we compared the results of the less invasive surgical stabilization (LISS) plate and the multi-angled, POLYAX plate in old-age patients.

Methods: A prospective, comparative observational study carried out in a tertiary care trauma center among 40 subjects (20 in each group) above the age of 60 years.

Among both groups of patients, diabetes and hypertension were the most common co-morbidity. It was observed that 25 (62.5%) of the patients had 12 - 16 weeks of the time of fracture union while 12 (30%) had 17 - 20 weeks and 3 (7.5%) had non-union, diabetes was observed to be affecting fracture union among both groups.

The fractures were classified according to Gustilo Anderson’s system of classification for compound fractures and the Muller AO system of classification. All patients were treated surgically either using a LISS plate or multi-angled, POLYAX plate, and functional outcome was compared at the end of one-year follow-up.

Results: Fracture union was found at the rate of 72.5% in LISS, and subsequently, it was 77.5% in POLYAX plate. As a result, only one patient from the POLYAX group and additionally, two from the LISS group needed another surgery, which is a revision surgery for the failure of the implant. The rate of complication was found to be more in the LISS plate.

Conclusion: Based on our findings, we conclude that elderly osteoporotic femur fractures will give a better union rate managed with Polyax plate than LISS.

Keywords: Femur; Distal end; LISS; PLYAX; OKS; KSS

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