Treatment Options for Distal Femur Fractures

Keudell, Arvind von; Shoji, Kristin; Nasr, Michael; Lucas, Robert E.; Dolan, Robert W.; Weaver, Michael J.

doi:10.1097/bot.0000000000000621

Cited by 77 publications

(53 citation statements)

References 14 publications

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“…Similar to periprosthetic distal femur fractures, native distal femur fractures with preexisting arthrosis are a challenge for orthopedic surgeons to treat as they are often intraarticular with bone loss due to comminution in patients with multiple medical comorbidities and poor bone stock [21] . Surgery has become the standard of care for displaced distal femoral fractures with treatment options including intramedullary nails, screw fixation, periarticular locked plating, and DFR [3] .…”

Section: Discussionmentioning

confidence: 99%

Single-stage bilateral distal femur replacement for traumatic distal femur fractures

et al. 2019

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Treatment of periprosthetic distal femur fractures and comminuted intraarticular distal femur fractures with previous arthritis remains a difficult challenge for orthopedic surgeons. Previous case series have shown that distal femur replacement (DFR) can effectively compensate for bone loss, relieve knee pain, and allow for early ambulation in both of these fracture patterns. Owing to the typical low-energy mechanism of these injuries, a bilateral injury treated with DFR is rarely encountered. We present a patient with traumatic open left Rorabeck III/Su III periprosthetic distal femur fracture and closed right intraarticular distal femur fracture (AO fcation 33-C2) with end-stage arthrosis treated with single-stage bilateral DFR. We suggest that in patients with similar injuries, single-stage bilateral DFR can provide the benefits of early mobilization and accelerated recovery.

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Section: Discussionmentioning

confidence: 99%

Single-stage bilateral distal femur replacement for traumatic distal femur fractures

et al. 2019

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“…If there is comminution and available subchondral bone is not enough for fixation with ordinary screws, you can fix them with headless screws (13). Even if there is not enough bone for headless screws, try esmaeili pins for holding the articular segments near each other and avoid missing joint segments.…”

Section: Pitfalls In Operationmentioning

confidence: 99%

Pitfalls in Distal Femur Fracture Fixation and a Literature Review

Siavashi¹

2016

J Orthop Spine Trauma

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Distal femur fracture is a critical fracture. It affects knee joint, which needs a wide range of motion. On the other hand, it is a weight bearing joint and needs stability for tolerating the weight of body. For achieving better results, it is necessary to have preoperative planning. It needs high quality radiography and a CT scan. Locking plates has good results in distal femoral fracture fixation. There are some pitfalls in reduction and fixation of distal femoral fractures. Attention to details is the key for success in these fractures.

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“…Moreover, patient outcomes with these types of fractures are generally unsatisfactory due to the proximity of the fracture to the knee joint [10], meaning that regaining full knee motion and function may be difficult. In addition, internal fixation above such fractures is disadvantageous since a lengthy non-weight bearing period is required following surgery, and significant complications such as malunion, nonunion, infection, and implant failure occur at relatively high rates in many reports [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Application of cortical bone plate allografts combined with LISS plates for fixation of comminuted distal femur fractures

Shi

Liu

Lin

et al. 2020

Preprint

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Background: At present, the management of comminuted distal femur fractures remains challenging for orthopedic surgeons. The aim of this study is to report a surgical treatment for comminuted distal femur fractures using supplementary medial cortical bone plate allografts in conjunction with the lateral less invasive stabilization system (LISS) plates, and to discuss the therapeutic effects of this treatment after long-term follow-up with patients. Patients and methods: From January 2009 to January 2014, the records of thirty-three patients who underwent supplementary medial cortical bone plate allografts combined with lateral LISS plate fixation were reviewed. Twenty-nine patients suffered from closed fractures and four had open fractures. Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the special surgery knee rating scale (HSS) used at the hospital. Results: Thirty patients were followed for 13 to 73 months after surgery, with an average follow-up time of 31.3 months. The mean time to bone union was 5.4 months (range of 3-12 months) and the mean range of knee flexion was 105.6º (range of 80º-130º). Of the remaining patients, 10 had a score of “Excellent” while 10 had a score of “Good” (the proportion of “Excellent” and “Good” scores was 67.7%). Three patients had superficial or deep infections, one patient had nonunion that required bone grafting and one patient had post-traumatic knee arthritis. No loosening of fixation or refracture had occurred in any patient at the time of the last follow-up appointment. Conclusions: Based on these promising results, we propose that supplementary medial cortical bone plate allografts combined with lateral LISS plates fixation may be a good treatment option for comminuted distal femur fractures. This treatment choice not only resulted in markedly improved stability on the medial side of the femur, but also satisfactory outcomes for distal femoral fractures.

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Treatment Options for Distal Femur Fractures

Cited by 77 publications

References 14 publications

Single-stage bilateral distal femur replacement for traumatic distal femur fractures

Single-stage bilateral distal femur replacement for traumatic distal femur fractures

Pitfalls in Distal Femur Fracture Fixation and a Literature Review

Application of cortical bone plate allografts combined with LISS plates for fixation of comminuted distal femur fractures

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