Treatment of Distal Femur Fractures With the DePuy-Synthes Variable Angle Locking Compression Plate

OBJECTIVES:To determine the failure rate of the DePuy-Synthes variable angle locking compression curved condylar plate (VA-LCP) and quantify failure modes. DESIGN:Retrospective review. SETTING:Level I Trauma Center. PATIENTS/PARTICIPANTS:One hundred thirteen patients with 118 OTA/AO classification 33A and 33C distal femoral fractures were included in the study. INTERVENTION:Internal fixation using only the DePuy-Synthes VA-LCP plate. MAIN OUTCOME MEASUREMENTS:Primary outcomes included mechanical failure rate of the DePuy-Synthes VA-LCP plate in open and closed fractures. Secondary outcomes included overall failure rate of treatment, risk factors for mechanical failure, and the specific location of failureloss of fixation in the proximal segment, implant failure over the working length, or failure of locking screw fixation distally. RESULTS:There were 11 total failures (9.3%) in 118 fractures. Failure rates for the closed and open fracture groups were 5.4% and 15.9%, respectively. Twenty patients (16.9%) required reoperation to promote union. Open fractures (P = 0.00475), the presence of medial metaphyseal comminution (P = 0.037), the length of the zone of comminution (P = 0.037), and plate length (P = 0.0096) were significantly higher in those with implant failure. Most failures (63.6%) were in the working length of the implant. CONCLUSIONS:The use of the Synthes VA-LCP is a viable option in distal femoral fractures and has an acceptable failure rate and reoperation to promote union rate. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.