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J Knee Surg 2013; 26(06): 441-444
DOI: 10.1055/s-0033-1347360
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Distal Femoral Locking Plates and the Posterolateral Corner

Jocelyn Ross Wittstein
1   Department of Surgery, Bassett Healthcare Network, Cooperstown, New York
,
Stephanie Watson Mayer
2   Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
,
Braden Mayer
2   Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
,
Brian Krenzel
2   Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
,
Chetan Deshpande
3   Department of Surgery, Mercer University School of Medicine, Savannah, Georgia
,
Robert Zura
2   Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

28 September 2012

07 April 2013

Publication Date:
21 May 2013 (online)

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Abstract

The purpose of this study was to evaluate the effect of minimally invasive submuscular placement of a distal femoral locking plate on the posterolateral structures of the knee. Eight fresh-frozen cadaveric knees were dissected after application of a lateral distal femoral locking plate through a minimally invasive submuscular approach. The lateral collateral ligament and popliteus tendon were identified and inspected for injury. Distances from the plate to the lateral collateral ligament and popliteus insertions were determined.

Neither the lateral collateral ligament nor the popliteus tendon was disrupted by the minimally invasive submuscular application of distal femoral periarticular locking plates. The mean distances to the lateral collateral ligament and popliteus tendon insertions were 2.5 and 6.6 mm, respectively.

Distal femoral locking plates can be applied in a minimally invasive manner without disrupting the posterolateral structures of the knee.

Keywords

posterolateral corner - locking plate - knee trauma
 

  • References

  • 1 LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med 2003; 31 (6) 854-860
    CrossrefPubMedGoogle Scholar
  • 2 Gollehon DL, Torzilli PA, Warren RF. The role of the posterolateral and cruciate ligaments in the stability of the human knee. A biomechanical study. J Bone Joint Surg Am 1987; 69 (2) 233-242
    CrossrefPubMedGoogle Scholar
  • 3 Grood ES, Stowers SF, Noyes FR. Limits of movement in the human knee. Effect of sectioning the posterior cruciate ligament and posterolateral structures. J Bone Joint Surg Am 1988; 70 (1) 88-97
    CrossrefPubMedGoogle Scholar
  • 4 Veltri DM, Deng XH, Torzilli PA, Maynard MJ, Warren RF. The role of the popliteofibular ligament in stability of the human knee. A biomechanical study. Am J Sports Med 1996; 24 (1) 19-27
    CrossrefPubMedGoogle Scholar
  • 5 Veltri DM, Warren RF. Anatomy, biomechanics, and physical findings in posterolateral knee instability. Clin Sports Med 1994; 13 (3) 599-614
    PubMedGoogle Scholar
  • 6 Kolb W, Guhlmann H, Windisch C, Marx F, Kolb K, Koller H. Fixation of distal femoral fractures with the Less Invasive Stabilization System: a minimally invasive treatment with locked fixed-angle screws. J Trauma 2008; 65 (6) 1425-1434
    CrossrefPubMedGoogle Scholar
  • 7 Kolb K, Grützner P, Koller H, Windisch C, Marx F, Kolb W. The condylar plate for treatment of distal femoral fractures: a long-term follow-up study. Injury 2009; 40 (4) 440-448
    CrossrefPubMedGoogle Scholar
  • 8 Kolb W, Guhlmann H, Windisch C, Marx F, Koller H, Kolb K. Fixation of periprosthetic femur fractures above total knee arthroplasty with the less invasive stabilization system: a midterm follow-up study. J Trauma 2010; 69 (3) 670-676
    CrossrefPubMedGoogle Scholar
  • 9 Schütz M, Müller M, Regazzoni P , et al. Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Arch Orthop Trauma Surg 2005; 125 (2) 102-108
    CrossrefPubMedGoogle Scholar
  • 10 Vallier HA, Immler W. Comparison of the 95-degree angled blade plate and the locking condylar plate for the treatment of distal femoral fractures. J Orthop Trauma 2012; 26 (6) 327-332
    CrossrefPubMedGoogle Scholar
  • 11 Weight M, Collinge C. Early results of the less invasive stabilization system for mechanically unstable fractures of the distal femur (AO/OTA types A2, A3, C2, and C3). J Orthop Trauma 2004; 18 (8) 503-508
    CrossrefPubMedGoogle Scholar
  • 12 Henderson CE, Kuhl LL, Fitzpatrick DC, Marsh JL. Locking plates for distal femur fractures: is there a problem with fracture healing?. J Orthop Trauma 2011; 25 (Suppl. 01) S8-S14
    CrossrefPubMedGoogle Scholar
  • 13 Hoffmann MF, Jones CB, Sietsema DL, Koenig SJ, Tornetta III P. Outcome of periprosthetic distal femoral fractures following knee arthroplasty. Injury 2012; 43 (7) 1084-1089
    CrossrefPubMedGoogle Scholar
  • 14 Davison BL. Refracture following plate removal in supracondylar-intercondylar femur fractures. Orthopedics 2003; 26 (2) 157-159
    PubMedGoogle Scholar
  • 15 Pujol N, David T, Bauer T, Hardy P. Transverse femoral fixation in anterior cruciate ligament (ACL) reconstruction with hamstrings grafts: an anatomic study about the relationships between the transcondylar device and the posterolateral structures of the knee. Knee Surg Sports Traumatol Arthrosc 2006; 14 (8) 724-729
    CrossrefPubMedGoogle Scholar
  • 16 Farrow LD, Liu RW. Lateral anatomic structures at risk during transepiphyseal anterior cruciate ligament reconstruction. J Knee Surg 2010; 23 (4) 209-213
    Article in Thieme ConnectPubMedGoogle Scholar