الفهرس 
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Abstract
Complex distal femoral fractures are challenging to orthopaedic
surgeons and there is no consensus on their treatment. The treatment
goals are: early mobilization, rapid fracture union, and minimal
complications. (1) Biological internal fixation is increasingly popular
with the introduction of minimally invasive plate osteosynthesis
(MIPO). The less invasive stabilization system (LISS) is based on
MIPO techniques. (2)
A biomechanical study has shown that LISS offered greater
angular stability and better remodeling than condylar buttress plates or
dynamic condylar screw fixation.(4,5)Moreover, the LISS is suitable for
the treatment of complex intra-articular fractures .
Distal femoral fractures account for about 7% of all femur
fractures. If hip fractures are excluded, one-third of femur fractures
involve the distal portion. A bimodal age distribution exists, with a
high incidence in young adults from high-energy trauma, such as motor
vehicle or motorcycle accidents or falls from a height, and a second
peak in the elderly from minor falls. Open fractures occur in 5% to
10% of all distal femur fractures.
Patients and methods :
A randomized prospective study of patients received in emergency
department of Souhag university hospital with the following criteria:
1. Skeletally mature patients with Distal femoral fractures .
2. Early measures done to traumatized patient in emergency
department and ABC system is followed .
3. Pre-operative X-ray is done , anteroposterior and lateral views .
4. Written consent from the patient and ethical committee.
5. Post-operative X-ray is done .
Schedule for follow up and after treatment :
Range-of-motion exercises are started 2 days after surgery if
fixation is stable.
Active quadriceps and hamstring exercises also can begin at this
time.
Touch-down weight-bearing only is allowed until fracture
consolidation.
If stable fixation has not been obtained, a more cautious
postoperative approach must be followed until healing is sufficient.
Follow up after 2 weeks for removal of the stitches.
Follow up every month for assessment of Union , Deformity , Soft
tissue healing , Pain through visual analogue scale for pain (VAS) ,
Function and range of motion .