Plate fixation in the treatment of adults with distal femoral fractures: history, present time, and prospects (world literature overview)

Introduction Distal femoral fractures are a challenging medical and social problem as they may occur at any age. All the available osteosynthesis types can be used to treat such injuries. However, despite the disadvantages, fixation with plates has been the most common and developed. Aim of study was to analyze the world literature and summarize the information regarding the use of plate fixation in the treatment of distal femoral fractures, identifying unresolved issues and promising directions. Materials and methods The following sources were used for collecting the information: Pubmed and E-library databases, publications of Elsevier, Springer and other publishing companies, materials of the Russian National Library, AO Surgery Reference on line. Results A review of global literature demonstrated that a minimally invasive approach which allows for bone fragment blood flow and stable fixation with a locking compression plate (LCP) are the most important factors that can improve the quality of treatment with plating. Discussion Plate fixation is still the most preferred method in the treatment of distal femoral fractures. In most severe injuries, accompanied by the medial support loss (33-A3, 33-C2 and 33-C3 fracture types according to AO classification), the use of not only the lateral but also the medial plate to achieve stable osteosynthesis has been discussed. Conclusion Further advance of the technology for treating these injures may be associated with designing an “anatomical” medial plate and a method for its minimally invasive implantation. Development of a lateral plate which could provide the stability similar to bilateral osteosynthesis seems even more prospective. Undoubtedly, such a plate would be useful in limb reconstruction surgery as well, for changing the external fixation to internal one after deformity correction and limb lengthening.