title: Minimally invasive plate osteosynthesis using a locking compression plate for distal femoral fractures.
abstract: OBJECTIVE
  To evaluate treatment outcomes of minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures in 31 patients.
  
  
  METHODS
  22 male and 9 female consecutive patients aged 21 to 65 (mean, 42) years underwent minimally invasive plate osteosynthesis using a locking compression plate (LCP) for distal femoral fractures. The causes of injury were vehicular accidents (n=24), falls (n=6), and assault (n=1). According to the AO classification, the fractures were classified as types A1 (n=10), A2 (n=7), and A3 (n=14). Most fractures were closed; 3 were Gustilo type-II fractures. Clinical and functional outcomes were assessed using the Knee Society Scores.
  
  
  RESULTS
  The mean operating time was 70 (range, 60-100) minutes. The mean length of hospital stay was 9 (6-14) days. The mean time to union was 3.7 (range, 2.8-4.6) months. The mean follow-up period was 18 (14-26) months. At the one-year follow-up, 29 of the patients had good or excellent outcomes. No patient had angular or rotational deformity of >10º. One osteoporotic woman with a type-A1 fracture had implant failure at 10 weeks and underwent revision surgery. Another patient with a type-A1 fracture had persistent pain on the lateral aspect of the distal thigh and underwent implant removal at 22 months. No patient developed deep infection, malunion or nonunion.
  
  
  CONCLUSIONS
  MIPO using a LCP achieves favourable biological fixation for distal femoral fractures with few complications. Bone grafting is not needed even in cases of metaphyseal comminution. Proper patient selection and preoperative planning are essential to prevent complications.
authors.affiliation: Lilavati Hospital and Research Centre, Mumbai, India. nayak.ortho@gmail.com
authors.forename: Ravi M
authors.initials: RM
authors.lastname: Nayak
authors.forename: M R
authors.initials: MR
authors.lastname: Koichade
authors.forename: Alok N
authors.initials: AN
authors.lastname: Umre
authors.forename: Milind V
authors.initials: MV
authors.lastname: Ingle
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D055815:Young Adult