- 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.