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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Condylar Buttress Plate



- Discription:
    - broad cloverleaf shaped plate which is designed to butress comminuted supracondylar fractures;
           - this plate may be especially indicated for comminuted distal fractures w/ a coronal shear frx;  
    - plate is designed to contour to the lateral aspect of the distal femoral cortex;

- Indications:
    - for severe comminution involving the lateral femoral condyle
    - for multiple intra-articular frx in the coronal or sagittal plane;
           - if there is a coronal plane frx, only device that can be used w/ any reliability is condylar butress plate;
    - when comminution is severe, a medial buttress plate is required to prevent varus settling of the fracture;
    - if there was a coronal split frx (or a frx w/ in most distal 2 cm of femur, neither a blade plate nor a distal condylar screw will attain 
           sufficient purchase in the reconstructed condyles;

- Disadvantages and Complications:
    - problem w/ this plate is that screws passing thru the distal drill holes do not have a fixed relationship to the plate;
         - hence plate may create a distracton or compression force, producing a varus deformity w/ distraction or valgus deformity w/ 
               compression;
    - screw head/plate junction of condylar buttress plate is not rigidly locked, and thus can slip with early loading of frx;
    - varus deformity:
          - early wtbearing on unhealed frx may result in varus deformity;
          - patient should avoid wtbearing ambulation until frx has healed, but early motion of knee is allowed;

- Surgical Stratedgy:
    - indirect reduction is normally used w/ the femoral distractor;
    - similar broad dynamic compression plate, which holds six, 6.5 mm cancellous screws;
    - always consider apply bone graft medially as well as a medial butress plate;
         - all type A2, A3, C1, C2, and C3 frxs stabilized by plate require bone graft medially;

- Post Op:
    - varus deformity:
         - early wtbearing on unhealed frx may result in varus deformity;
         - patient should avoid wtbearing ambulation until frx has healed, but early motion of knee is allowed


Double plating of comminuted unstable fractures of the distal part of the femur.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, May 24, 2012 4:05 pm