title: Supracondylar osteotomy of the paediatric femur using the locking compression plate: a refined surgical technique.
abstract: Locking compression plates (LCP) have been developed for paediatric patients, and these provide safe bone fixation and allow for immediate weight-bearing. These plates are becoming increasingly popular and are proving to especially useful for the treatment of proximal and distal (supracondylar) femoral osteotomies. They are thought to provide better grip in osteoporotic bone. The technique has been described in the provider's manual as well as recently by Joeris et al. (Int Orthop 2012: 36:2299-2306). The LCP system offers optimal stability after the final fixation, but temporary fixation using the originally described method is unstable, and we consider the medialisation instrument unsatisfactory as it has very small contact area with the lateral aspect of the femur and does not provide sound rotational control. For this reason we have developed a technique whereby temporary, stable fixation using fine K-wires can be attained for the proximal, diaphyseal fragment, following sound fixation with locking screws of the distal fragment. This procedure allows for full clinical (including rotation) and radiographic assessment intraoperatively, as well as fine adjustment in all three planes. This modification enables optimal correction before the final fixation and avoids unnecessary, large drill holes which may otherwise act as dangerous tress risers, endangering stability and weight-bearing. Here we describe a refined technique of the supracondylar femoral osteotomy using the paediatric LCP Condylar Plate.
authors.affiliation: Neuroorthopaedics, University Children's Hospital Basel, Spitalstrasse 33, 4031, Basel, Switzerland.
authors.forename: Reinald
authors.initials: R
authors.lastname: Brunner
authors.affiliation: Neuroorthopaedics, University Children's Hospital Basel, Spitalstrasse 33, 4031, Basel, Switzerland.
authors.forename: Carlo
authors.initials: C
authors.lastname: Camathias
authors.affiliation: Department of Orthopaedics, Royal Hospital for Sick Children, Edinburgh, EH9 1LF UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Gaston
authors.affiliation: Neuroorthopaedics, University Children's Hospital Basel, Spitalstrasse 33, 4031, Basel, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Rutz
keywords: Femoral osteotomy; Locking compression plate; Supracondylar osteotomy; Technique