Anatomical Evaluation of Optimal Plate Positioning for Distal Femur Locking Compression Plates: A Cadaveric Study in the Indian Population

Background: Anatomically pre-contoured distal femur locking compression plates (DF-LCP) are based on Western morphometric data and may not fit Indian femora accurately, risking intra-articular screw penetration or posterior cruciate ligament (PCL) impingement. To identify Objective: the optimal DF-LCP position using consistent bony landmarks in Indian femora. Forty-eight adult cada Methods: veric femora were studied. DFLCPs from three manufacturers were applied at four positions relative to the lateral epicondyle—S3 (3 mm superior), I3 (3 mm inferior), 0 (neutral), and A3 (3 mm anterior). Radiographic and clinical assessments, including notch-view imaging, evaluated screw penetration and PCL proximity. Overall screw penetration was 54.2 %. The S3 position had 0 % penetration, while I3 had 1 Results: 00 %. Shorter femora (36 ± 3 cm) showed more penetration than longer ones (42 ± 3 cm). Placing the DF-LCP about 3 mm proximal to the Conclusion: lateral epicondyle (S3 position) minimizes joint and PCL violation. Intra-operative notch-view verification and plate designs based on Indian morphology are recommended.