Locked plating for femoral fractures in polio patients.

Background: Femoral fractures in polio survivors present unique challenges; the bone is often small, deformed, osteoporotic and hypovascularized. Locked compression plating aided in achieving a better construct stability of osteoporotic fractures.

Methods: A total of 13 unilateral femoral fractures in adult polio patients were fixed with locked compression plating in a prospective study. Mean age was 49.8 years (range 34-62). In 6 cases, the small size of the bone matched only narrow plates, and in 6 cases the plate was contoured to fit the cortex. Average follow-up period was 18.4 months (range 12-24).

Results: Radiological evidence of union was apparent in 12 cases after 12-20 weeks (mean 16.3). One case was considered ununited after 28 weeks and progressed to union with bone grafting after another 12 weeks. At the end of the follow-up period, 12 patients returned to their prefracture Vignos disability scale, only the case that experienced nonunion showed functional deterioration.

Conclusion: The locked compression plate withstood fixing femoral fractures in polio patients, addressing the challenges of a smaller, osteoporotic, less vascularized and sometimes deformed femur.