Evaluation of Operative Outcomes of Open Fractures of Distal Femur

Abstract

Introduction: Open fractures of the distal femur are a uncommon and intricate type of injury that typically occurin individuals who have sustained multiple traumas. These types of fractures are often accompanied by bone loss,contamination, damaged soft tissue, and a patient’s overall poor health condition. The purpose of this study is toexamine the outcomes of patients who were treated for open distal femur fractures using a staged protocol, whichinvolves initial external fixation with debridement, followed by definitive fixation using an anatomical lockingplate and bone grafting at a later stage.Method: The study included a group of 20 patients of open distal femurfractures who were operated withtemporary external fixator and later on converted to definitive fixation with condylar locking plate with bonegrafting. These patients were operated with our staged protocol and clinical outcome was evaluated using thefunctional evaluation scoring system by Sander’s et al and Knee Society Scoring. Out of these 20 patients, 1 waslost to follow up at 3 months and 2 others were lost to follow up at 6 months. These 3 were excluded from ourstudy.Results: Fracture union was seen in all 17 patients. The average time to union was 22.65+3.3 weeks. Two patientswere complicated with infection and delayed union. Ilizarov application was doneto achieve union and gainlength once the infection subsided.Conclusion- Staged protocol of temporary external fixator followed by definitive fixation with condylar lockingplate and bone grafting is a safe and reliable method for the management of open distal femur fractures.