The Benefit of Locked Plate in the Management of Osteoporotic Distal Femur Fracture in the Elderly

Author(s): Conde Mamady Sekou, Camara Ibrahima Sory, Bah Amadou Tanou, Diallo Hawa Lamarana, Ba Papa Amadou, Niang Coumba Diouf

Introduction: Osteoporotic distal femur fractures are becoming increasingly common in the elderly. The purpose of this study was to evaluate the efficacy of locked plate in the management of osteoporotic distal femur fractures in elderly.

Materials and method: This was an observational and descriptive study. Patients underwent surgery between July 1, 2023, and June 30, 2024. Patients had a distal femur fracture on porotic bone classified according to the the Association for the Study of Osteosynthesis criteria. Fractures fixation were done by a lateral locked plate. The efficacy of the plate fixation was evaluated by analyzing radiological (anatomical angles and bone union), clinical and functional (satisfaction, pain, gait, knee mobility, morphotype, knee stability, limb inequality) parameters.

Results: The series included 14 patients. There were 2 men and 12 women. The mean age was 75.29 (61 and 96) years. The fractures were type A2 (n=7), A3 (n=5), C2 (n=1) and C3 (n=1). The mean surgical time was 105.35 (85 and 150) minutes. The mean follow-up was 8 (5 and 10) months. The fractures healed between 3 and 6 months. The anatomical axes were correct in all cases. The mean anatomical posterior distal femur angle was 83.07° (80 and 86), that of anatomical lateral distal femoral angle was 80.93° (79 and 83). The mean knee flexion was 97.93° (50 and 131). The knee was painless (n=11). All patients were satisfied. No knee instability was observed. Limb length discrepancy was less than 2 cm in two patients. The mean functional international knee society score was 87.1 (80 and 95). Complications were observed in 4 patients.

Conclusion: Locked plate fixation of distal femur fractures on porotic bones in elderly people allows fracture healing, restores anatomical axes of the distal femur and gives satisfactory knee functional outcomes in the medium term.