Prospective comparative study of different modalities of distal femoral fracture management

Abstract

Introduction: Fractures of distal femur contribute 4 % of all femoral factures and they present a complex problem. The mechanism of injury in most distal femoral fractures is thought to be axial loading with varus/valgus or rotational forces. The distal femoral fractures are difficult to manage. There are wide variety of choices available to treat these complex fractures which ranges from conservative management to operative management. In surgical fixation, we have variety of armamentarium available from angled blade plate to locking compression plate. However no single management has overcome all of the problems associated with this fractures. In this study fractures of distal femur treated by various conservative and surgical methods to determine the personality of each fracture and patient and the treatment has been given accordingly. Materials and Methods: All the patients having fractures of distal femur. who were treated and followed up in Shri.Chatrapati Shivaji Maharaj General Hospital, Solapur in the period July 1999 to December 2000 are included. Pathological fractures and fractures in children are not included in this series. Data of the patient was collected in the form of name, age, sex, address, occupation, mechanism of injury time since injury and associated injuries. Results: Final result were rated using Neer's Rating system, there were excellent in 61% of operartive and 56% of conservatively treated distal femoral fractures. Also good, fair and poor outcome has been seen in almost similar proportion of distal femur fractures patients when compared conservative versus operative. Conclusion: Dynamic condylar screw with plate and 95 degree condylar blade plate are effective internal fixation for treatment of fractures of distal femur. Result of intramedullary supracondylar nails are encouraging. Undisplaced unicondylar fractures can be treated satisfactory by conservative methods. The AO/ ASIF (Muller et al) classification is useful for planning of surgery.