The Clinical and Radiological Evaluation of Far Cortex Locking Plate in Distal Femur Fractures

Introduction Locking plates in distal femur fractures were associated with a high rate of non-union and hardware failure. To overcome these drawbacks far cortex locking (FCL) concept was introduced. It is a novel bridge plating strategy to enhance interfragmentary motion for the promotion of secondary bone healing while retaining sufficient construct strength. The present study evaluated the effects of diaphyseal FCL fixation on fracture healing for periarticular locking plates used for fixation of distal femur fractures.  Materials and methods Our cohort was of 11 consecutive patients who presented to emergency after distal femur fracture and underwent surgery with the FCL plate between January 2015 and January 2016. Clinical (KOOS) and radiological evaluation of all patients was done to look for knee scores and union. Also, other complications like infection, non-union, painful hardware, implant failure were recorded  Results No non-union or hardware failure was observed in our cohort of 11 patients. Early callus formation was seen and partial weight-bearing was started at an average of 6 weeks (5-8 weeks). Average time to clinical healing was 10 weeks (8-13 weeks) whereas radiographic union was seen at 16 weeks (14-17 weeks). One patient with an open fracture had superficial surgical wound infection which healed uneventfully after one debridement and with IV antibiotics. The average knee injury and osteoarthritis outcome score (KOOS) at final follow-up was 91 (87-95) in our cohort. Conclusion FCL is an effective method to reduce construct stiffness, promote early callus formation, decrease non-union rate and achieve biological healing while retaining sufficient strength to prevent hardware failure.