Bridge plating osteosynthesis of 20 comminuted fractures of the femur

We retrospectively studied the outcome of 20 comminuted fractures (20 patients, 15 men) of the femur treated in accordance with the principles of indirect reduction and biological osteosynthesis technique. The patients were followed for mean 1.5 (1-4.5) years. 11 fractures were subtrochanteric (type C), 6 complex diaphyseal and the remaining 3 were supracondylar (2 type C3 and 1 type A3); 3 fractures were open (type I, II, IIIA). Subtrochanteric fractures were treated with either 95 degrees dynamic condylar screw (DCS; 5 fractures) or with 135 degrees dynamic hip screw (DHS; 6 fractures). Autocompression plates (ACP) implants were chosen for diaphyseal fractures in 4 fractures, and a limited contact dynamic compression plate (LC/DCP) implant in 2. The 3 supracondylar fractures were treated with a 95 degrees DCS implant (1 fracture) and the Condylar Buttress Plate (2 fractures). 11 fractures were bone grafted. There were no immediate postoperative complications. All fractures united on an average of 5 months, irrespective of use of bone grafts. Late complications consisted of mild knee stiffness (4 patients) and 1-2 cm shortening (4 patients).