Fracture healing with distal femoral titanum locking plates in patients with distal femoral fractures

Brief name: Distal femoral locking plates used for the treatment of distal femoral fractures and applied in two modes: Long working length versus short working length. Materials: Titanium distal femoral locking plates will be applied through surgery. Procedures: Surgery: Application of locking plates to patients of distal femoral fractures under anaesthesia and tourniquet control through lateral thigh incision in group A(long working length) and group B(short working length) Who: The operating surgeon will have minimum of 5 years post graduate experience in Orthopaedics & Traumatology Mode of delivery: It will be face to face.All patients with distal femoral fractures will be admitted in hospital in Orthopaedics & Traumatology Unit as soon as they are presented to hospital for treatment.After informed written consent each patient will operated upon individually. Number of times: Each patient in each group will be operated upon only once initially.(only one session) The duration of surgery(session) will last for one and half hour to two hours approximately.After surgery each patient will be seen face to face every 4th week for the first three months and then every three months till two years.If any complications of surgery is reported in the follow up visits,it will be dealt with accordingly at that time. Location: The intervention(surgery) will be performed on patients in Hospital(Lady Reading Hospital, Peshawar,Pakistan),This hospital is the biggest hospital of the province with a very large catchment area and all patients of long bone fractures are initially brought here for treatment. personalised what: Patients of distal femoral fractures will be divided in two groups and operated upon with distal femoral locking plates applied in long working length or short working length mode. why: Variations in the working length of a titanium locking plate affect stiffness and interfragmentary movements of a fracture and its healing.We hypothesize that longer working length of a titanium locking plate has less nonunion and plate breakage rates when: As soon as the patients of distal femoral fractures are presented in hospital and they gave informed consent for surgery and participation in study, they will be operated upon. How this will occur: All patients of distal femoral fractures meeting the inclusion criteria presenting to hospital for treatment and willing for surgery will be enrollment in the study and will be operated in hospital. All the patients will be randomized into two groups i,e, group A(long working length) and group B(short working length). In the long working length plating all the combi screw holes overlying the fracture or comminution will be left empty plus two combi empty screw holes will be left proximal to the fracture in the intact bone.In the short working length no combi screw holes in the intact bone near the fracture will be left empty.