Locked plate fixation for femoral shaft fractures

Fifteen patients with a mean age of 31 years, who had sustained different types of femoral shaft fracture, were treated by locked plate fixation using standard AO dynamic compression plates (DCP). The fracture was open in five patients and ten had other significant injuries. Thirteen patients were available for follow-up at a mean period of 5 months (range, 3–10 months). All fractures united and the mean time to full weight bearing was 8 weeks. Screw failures, with breakage or bending, occurred in five patients and resulted in loss of alignment of the fracture in one. Nine patients regained a full active range of movement of the knee, two had an extension lag of 10° and two had restricted flexion. The strength of the quadriceps muscle was grade 4 to 5 in ten patients and grade 3 in the remaining three. At the end of the study period ten patients had returned to their normal activities, one used a walking stick and two remained under a rehabilitation programme. Our preliminary results suggest that locked plates may offer a useful alternative technique for the treatment of femoral shaft fractures.