Distal Femoral Fractures

Abstract

Distal femur fractures are increasing injuries in our environment, due to their close relationship with the aging of the population. The diagnosis and treatment of these injuries have evolved in recent years, and the availability of new tools allows us to improve the results of our patients. Techniques such as dual nail-plate or plate-plate fixation emerge as an option in complications and complex fractures, and augmentation with PMMA may be an option in very low-density bones. To use these new techniques, anatomical knowledge, especially of the medial aspect of the femur, is essential. Many recent publications have studied the use of minimally invasive techniques with safe pathways. Throughout the following pages, we give a glimpse of the novelties in the treatment of these fractures, and we review the classic concepts.

Comprehensive Review on Distal Femur Fractures: From Epidemiology to Treatment Strategies

“…Distal femur fractures often coincide with additional injuries and underlying health conditions. In elderly patients who frequently sustain distal femur or hip fractures, compromised bone quality and the presence of multiple medical comorbidities contribute to a heightened mortality risk [11,12]. Conversely, in young patients subjected to high-energy trauma, fractures tend to be intra-articular, characterized by increased displacement and comminution, and are often accompanied by more severe soft tissue compromise.…”

“…Patients may also be unable to bear weight, and the affected leg may appear shorter than the unaffected one [22]. These fractures typically occur following twisting motions or falls, with patients frequently seeking medical attention after experiencing a fall or traumatic incident [10,12]. Diagnosis primarily relies on radiographic imaging, with computed tomography (CT) studies often necessary to evaluate potential intra-articular extension [10,21,22].…”

“…Current management options for distal femur fractures include distal femur replacement (DFR), surgical fixation (SF), or conservative management, with surgical treatment typically indicated for most displaced and intra-articular fractures [28]. Treatment goals aim to restore length, alignment, rotation, and articular congruence while mitigating these fractures' high morbidity and mortality [12].…”

“…Typical complications linked with distal femur fractures encompass pin-tract infection, deep infection, loss of reduction, malunion, and knee stiffness [12,22,48]. These fractures commonly exhibit comminution, intra-articular involvement, periprosthetic association, and soft tissue damage, rendering their management notably challenging [1,48].…”