Minimally Invasive Plate Osteosynthesis for Comminuted Femoral Fractures

This prospective study presents 27 male patients with unilateral closed comminuted femoral fractures treated by the minimally invasive plate osteosynthesis technique. They were 6 subtrochanteric, 3 diaphyseal and 18 distal fractures. Indirect reduction was done without exposure of the comminuted fragments. Two separate incisions were used for sub muscular insertion of the plate. DHS was used in 7 cases, broad DCP in 2 cases and eondylar buttress plate in the the 18 distal fractures. The mean follow-up interval was 18 months (range 9-28 months). All fractures united (100%) without bone grafting after a mean interval of 4.3 months (range 3-5 months). No cases of nonunion or infection were reported. According to Neer s scale, the results were excellent and satisfactory in 24 cases (88.9%) and unsatisfactory in 3 patients (11.1 % ) with no failures. Few complications occurred in the form of 1 cm shortening in 2 cases and I 0° valgus in 2 cases. The minimally invasive plate osteosynthesis technique proved to be useful for treatment of comminuted femoral fractures especially those in which the interlocking nail can not be used. It is technically not difficult, has a high rate of success and low incidence of complications.