Treatment Options for Distal Femoral Fractures

Olivera LUPESCU, Mihail NAGEA, Cristina PATRU, Cornelia VASILACHE and Gheorghe Ion POPESCU

ABSTRACT

Introduction: Due to their high complication rate and negative impact of those complications upon the knee and the whole lower limb, distal femoral fractures require optimal restoration of the functional anatomy and stable fixation thus allowing early recovery. This paper presents the experience of the authors regarding the indications and results of the most accepted surgical methods, including late complications affecting the knee

Material and method: 36 patients with closed distal femoral fractures (21-81 yrs old) operated in Bucharest, Clinical Emergency Hospital, Orthopedics and Trauma Clinic, were retrospectively studied from the point of view of the fracture and implant type, functional results and complications

Results: Most of the fractures were high energy comminuted fractures (27 cases), mainly with articular involvement. Retrograde nail was used in type A fractures, while plating (LCP) was the main indication for type C fractures. The functional outcome was correlated with the fracture type and the incidence of complications was higher in type A3, C2 and C3 fractures

Conclusion: Anatomical reduction of the articular surface, restoration of functional anatomy and stable fixation are mandatory for an optimal knee function after distal femoral fractures. Failure to achieve them, due to the character of the fracture or to improper fixation, is followed by significant functional deficit, thus delaying the patients’ recovery.

Keywords: distal femoral fracture, articular fracture, angular stability plate, retrograde nail

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