LCP Versus LISS in the Treatment of Open and Closed Distal Femur Fractures: Does it Make a Difference?

Objectives: We compared the postoperative complication rates between the less invasive stabilization system (LISS) plating and locking compression plate for open and closed distal femoral fracture fixation for superiority. Design: Retrospective Review. Setting: Multicenter. Participants: Patients identified through a hospital database who were treated for supracondylar femur fractures using LISS or LCP techniques between January 2005 and July 2010. Intervention: Medical history, patient demographics, injury characteristics, presence of polytrauma, and surgical characteristics were collected for each patient. Main Outcome Measurements: χ2 and logistic regression analysis was performed to compare postoperative infection and nonunion/reoperation regarding both plating techniques. Results: Of 339 distal femoral fractures, 185 (54.6%) were repaired with a LISS plate and 154 (45.4%) were repaired with a LCP. Multivariate analysis revealed only open fractures to be a risk factor for nonunion (Odds ratio 2.42, P = 0.01) and infection (Odds ratio 3.47, P = 0.02), regardless of device used. No difference was seen between either plate type in infection, plate failure, or nonunion. Conclusions: Postoperative infection and nonunion rates are comparable between LISS and LCP for both open and closed distal femoral fracture fixation. As no difference was detected between plates, either may be used to treat distal femur fractures. Nonunion rate was higher than expected based on previous reports. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.