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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.