Functional outcomes of distal femoral fractures treated with locking compression plates in Yemen: A prospective study

Background: Distal femoral fractures (DFFs) present significant therapeutic challenges owing to their anatomical complexity and variable outcomes, particularly in resource-limited settings, such as Yemen, where high-energy trauma from road traffic accidents is prevalent. Locking compression plates (LCPs) have emerged as promising treatment modalities in such contexts; however, their efficacy remains underexplored. This study aimed to evaluate the functional outcomes and complications of DFFs treated with LCPs in Sana’a, Yemen. Methods: This prospective cohort study was conducted at Al-Kuwait University Hospital from March 20, 2022, to April 20, 2024, enrolling 18 patients with DFFs treated using LCPs. Patients underwent monthly follow-ups for 9 months, with functional outcomes assessed using Neer’s scoring system, which categorizes results as excellent (>85), good (70–85), fair (55–69), or poor (<55). Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 26.0. Results: Among 18 patients (mean age: 36.8 ± 13.8 years; 61.1% male), 50.0% sustained fractures from road traffic accidents, reflecting Yemen’s trauma profile. The Orthopedic Trauma Association (AO/OTA) classification identified A3 fractures as the most common (27.8%). Neer scores averaged 78.2 ± 12.6, with 38.9% excellent (7/18), 44.4% good (8/18), 11.1% fair (2/18), and 5.6% poor (1/18) outcomes. Excellent or good results (83.3%) were consistent across sexes (p ;= ;0.81) and fracture types (open vs. closed; p ;= ;1.0). Complications occurred in 27.8% (5/18) of patients, including superficial infection (11.1%), deep infection (5.6%), and delayed union (11.1%), with a non-significant trend toward poorer outcomes in affected patients (60% vs. 92.3%; p ;= ;0.15). No non-unions were observed. Conclusion: LCPs achieved excellent or good functional outcomes in 83.3% of cases, with a 27.8% complication rate, supporting their efficacy for A-type and osteoporotic fractures in resource-constrained, trauma-heavy settings. Larger studies with extended follow-up periods are essential to validate these findings and assess long-term risks, such as posttraumatic arthritis.