90° 3.5 and 5.0 mm LCP Pediatric Condylar Plate

James B Hunter, Richard Reynolds, Theddy Slongo, Reinald Brunner
The 90° LCP pediatric condylar plate is mainly indicated for children and adolescents suffering from cerebral palsy who require distal femoral osteotomies. The incidence of CP is 23:1000. The current LCP pediatric hip plates are not optimal for stabilizing this osteotomy since their screw shaft angle is not 90°.

The condylar plate (Fig 1) is intended for use in pediatric patients up to adolescence and for small-stature adult patients corresponding to age, size, and bone quality. Specific indications include:

  • Fixed flexion contracture of knee in neurological conditions
  • Deformity correction in the distal femur regardless of etiology
  • Rotational malalignment of the femur (if distal correction is preferred)
  • Supracondylar fractures of the femur

The 90° LCP pediatric condylar plate is available in 3.5 and 5.0 mm with 3, 5 and 7 shaft holes available in each. There is one symmetrical plate for right and left corrections and all plates are available packed non-sterile and sterile. The plate is from the same family of plates as the LCP pediatric hip plates and is inserted using the same instrumentation.

The condylar plate is contoured so that distal screws will be at 90° to the midline of the shaft if the plate is fitted on the surface of the bone (Fig 2). Generally, the distal screws should be parallel to the growth plate in the coronal plane, although the surgeon must take care to ensure that there is no deformity of the distal fragment which would negate this assumption.

A 12-year-old girl presented for the first time to the cerebral palsy clinic. Although weak as well as spastic she was able to stand and step and wished to walk better. Physical examination revealed fixed flexion deformity of both knees. Distal femoral osteotomy with some shortening was the preferred option as hamstring lengthening and posterior knee capsule release would have caused further weakening.

Osteotomies were stabilized with the 5.0 mm LCP pediatric condylar plate. Postoperative management was non-weight bearing in splints, followed by weight bearing and rehabilitation at 6 weeks. Osteotomies healed uneventfully.

Case provided by James B Hunter, Nottingham, UK


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