Ilizarov ring fixation and fibular strut grafting for C3 distal femoral fractures.

PURPOSE. To evaluate treatment outcome following surgical repair of C3 distal femoral fractures using autogenous fibular strut, cortico-cancellous bone grafting, and Ilizarov ring fixation. METHODS. A total of 15 patients with type C3 fractures (supracondylar and intercondylar fractures, with multiplane articular injury) underwent surgical repair at St. John's Medical College Hospital between 1994 and 2001, using autogenous fibular strut, cortico-cancellous bone grafting, and Ilizarov ring fixation. 13 were seen for ongoing follow-up and assessment. Definitive surgery was undertaken at a mean of 3 weeks after admission. Postoperatively, weight-bearing and mobilisation exercise were begun in 2 to 4 weeks. RESULTS. The mean follow-up period was 47 months. Union was achieved in all 13 cases by an average time of 19 weeks. At the last follow-up, the mean range of knee motion was 77 degrees. Assessment of functional outcome (using Neer's scoring criteria) revealed 10 cases with good or satisfactory outcomes, and 3 cases with poor or unsatisfactory results. CONCLUSION. Surgical repair with a fibular strut, cortico-cancellous bone graft and Ilizarov ring fixation appears a suitable treatment option for C3 distal femoral fractures.