Abstract

Aim: of the study was to evaluate and compare the results of different modalities of operative management of distal femoral fractures. Material and Method: The present study was conducted on 48 patients having fractures of the distal femur (involving distal 15cm of the femur).The cases were picked up from the patients treated at two tertiary care hospitals by open reduction and internal fixation from July 2014 to July 2018. Both anatomical and functional results were analyzed and graded. Results: Age of the patients operated upon ranged from 16-75 years (Mean age 41.6years). Male-dominated in our series, comprising 72.91% (35 out of 48 cases). All patients in our series had unilateral involvement of distal femoral fractures. The right side was however involved more i.e. 29 out of 48 (60.4%). The most common mode of the accident in our series was automobile accident (91.67%).42 out of 48 were closed fractures (87.5%), whereas the remaining 6 patients (12.5%) had open grade I type of fracture. Associated injuries were observed in 13 out of 48 cases in our series (27%). In most of the patients, the implant used was either a dynamic condylar screw or a distal femur plate. 41 out of 48 patients (85.42%) were discharged from the hospital within 7 days. Conclusion: For Distal femoral fractures early open reduction, rigid fixation allows accurate anatomical alignment, reconstruction of articular surfaces joint congruity and it offers opportunities for early post-operative knee mobilization and prevents frequent problems of limitation of knee movements, nonunion and osteoarthritis.

Highlights

  • Material and Method: The present study was conducted on 48 patients having fractures of the distal femur.The cases were picked up from the patients treated at two tertiary care hospitals by open reduction and internal fixation from July 2014 to July 2018

  • The most common mode of the accident in our series was automobile accident (91.67%).42 out of 48 were closed fractures (87.5%), whereas the remaining 6 patients (12.5%) had open grade I type of fracture

  • Distal femoral fractures constitute about 10- 15% of all fractures of the femur [1]

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Summary

Introduction

The optimum treatment for the fractures of the distal femur in adults continues to be debated until today. Till recently it was being managed as an extension of femoral shaft fracture treated with skeletal traction supplemented by manual manipulation of fracture fragments. Stewart MJ et al [2] advocated cast bracing for the management of distal femoral fractures. Recent advances have improved the overall results of the surgical treatment of these fractures. These advancements include improved surgical instrumentation, rigid fixation, improved rehabilitation without postoperative plaster cast immobilization, and immediate postoperative knee movements Connoly J. Al [3] and Mooney V et al [4]

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