Locking compression plate in distal intra-articular femoral fractures: The swashbuckler's approach

Abstract

Background: Distal femoral intra-articular fractures present a serious surgical challenge to an orthopedic surgeon. These fractures are usually complex and are difficult to treat, and the operative treatment is usually recommended. Problems encountered in the fixation of these fractures include poor exposure of the articular surface, loss of fixation, and joint incongruence. Materials and Methods: This was a prospective review of all patients treated with distal femoral locking plates (including patients presenting with nonunion) between January 2017 and January 2018 using the Swashbuckler's approach. Fractures were categorized using the AO/OTA classification. Patients with AO type A fractures were excluded from this study. Results: Six patients (5 females and 1 male) were recruited into this study. The mean age of the patients was 43.2 years (age range of 31–63 years). Mechanism of injury was road traffic accident in 83.3% of cases. The mean time for radiological union was 12 weeks, and all (100%) patients achieved union without any further intervention. Conclusion: The use of the Swashbuckler's approach for distal intra-articular fractures improves exposure of the articular surface and aids reduction and proper application of the locking distal femoral plate. High union rates can usually be achieved with these implants.