Management Of Distal Femoral Fractures Research Articles

The functional outcome of surgical management of distal femur fractures using a distal femoral locking compression plate.

Objective: To evaluate the functional outcomes following surgical intervention for distal femur fractures using femoral locking compression plates. Study Design: Descriptive study an Observational study. Setting: Department of Orthopedics, MTI Mardan Medical Complex in Mardan. Period: January 2023 to December 2023. Methods: Was conducted on 86 patients with distal femur fractures treated with femoral locking compression plates at the Orthopedic Ward. The sampling method employed was non-probability consecutive sampling. All surgeries were performed using a standardized technique by an experienced surgeon. Functional outcomes were assessed using the Oxford Society score six weeks post-procedure. Data analysis was conducted using SPSS 23, with significance set at p ≤ 0.05. Results: Of total 86 patients, n=57(66.3%) were male while n=29(33.7%) were female. Mean age was 35.43±10.49. Overall, 39 patients (45.3%) had excellent functional outcomes, 22 patients (25.6%) had good functional outcomes, 13 patients (15.1%) had fair functional outcomes, and 12 patients (14.0%) had poor functional outcomes. After cross tabulation with functional outcomes, gender and BMI were found insignificant with p value of 0.584 and 0.399 respectively. While diabetes, hypertension and age was found to be significantly associated with functional outcomes with p value of <0.001,0.005 and <0.001 respectively. Conclusion: The use of locking compression plates for distal femur fractures resulted in predominantly favorable functional outcomes with minority of patients experiencing poor outcomes. Additionally, diabetes, hypertension, and age emerged as significant predictors of functional outcome.

Current Concepts in Management of Distal Femur Fractures

Recent studies report the overall incidence of distal femur fractures as 8.7/100,000/year. This incidence is expected to rise with high energy motor vehicle collisions and elderly osteoporotic fractures in native and prosthetic knees keep increasing. These fractures are more common in males in the younger age spectrum while females predominate for elderly osteoporotic fractures. Surgical treatment is recommended for these fractures to maintain articular congruity, enable early joint motion and assisted ambulation. Over the last two decades, development of minimally invasive and quadriceps sparing surgical approaches, availability of angle stable implants have helped achieve predictable healing and early return to function in these patients. Currently, laterally positioned locked plate is the implant of choice across all fracture patterns. Retrograde with capital implantation of intramedullary nails with provision for multiplanar distal locking is preferred for extra-articular and partial articular fractures. Even with these advancements, nonunion after distal femur fracture fixation can be as high as 19%. Further recent research has helped us understand the biomechanical limitations and healing problems with lateral locked plate fixation and intramedullary nails. This has lead to development of more robust constructs such as nail-plate and double plate constructs aiming for improved construct strength and to minimise failures. Early results with these combination constructs have shown promise in high risk situations such as fractures with extensive metaphyseal fragmentation, osteoporosis and periprosthetic fractures. These constructs however, run the risk of being over stiff and can inhibit healing if not kept balanced. The ideal stiffness that is needed for fracture healing is not clearly known and current research in this domain has lead to the development of smart implants which are expected to evolve and may help improve clinical results in future.

Functional and Radiological Outcomes of Distal Femur Fractures treated with Less Invasive Stabilization System versus Dynamic Condylar Screw

Introduction: Fractures in the distal femur are quite rare, comprising around 0.4% of all fractures and 3% of femoral fractures. Managing distal femur fractures has been a subject of debate, but recent developments favor indirect reduction and minimally invasive approaches. The objective is to find a harmonious equilibrium between the mechanical stability of the fractured segments and their biological viability. Given their elevated complication rate, achieving optimal restoration of functional anatomy and ensuring stable fixation is imperative for prompt recovery from distal femoral fractures. Comparison of less invasive stabilization system versus dynamic condylar screw fixation in treatment of distal femur fractures is subject of ongoing debate as to which one is better. Aims and Objectives: To compare the functional and radiological outcomes of distal femur fractures treated with less invasive stabilization system versus dynamic condylar screw fixation. Place and Duration of study: A randomized clinical trial was conducted in the Orthopedic Department of Sheikh Zayed Hospital, Lahore, from July 2, 2020, to January 1, 2021. Material and Methods: A randomized clinical trial was conducted at Sheikh Zayed Hospital in Lahore over a six-month duration. In total 104 patients who fulfilled the inclusion criteria were admitted to the Orthopedic Department via Emergency and OPD. Demographic data and medical histories were taken. The sample size consisted of 52 patients in each group, with random allocation to either the LISS (A) or DCS (B) groups determined by a lottery method. Follow-up appointments were scheduled for all patients at one month, three months, and six months post-surgery. Radiological outcome was evaluated at each follow-up visit while functional outcome assessed at sixth monthly follow up. Data analysis was performed using the SPSS: version 22, considering p ? 0.05 as significant. Results: Frequency of functional outcome was i.e. excellent (32.7%), good (14.4%), fair (2.9%) in group A and excellent (27.9%), good (31.7%), fair (7.7%) in group B (p-value>0.05). Mean fusion time was 18.67±3.04 in group A and 19.62±4.36 in group B (p-value>0.05). Conclusion: Our findings indicate no substantial distinction between the two groups. Using DCS or LISS, both methods yield favorable outcomes with negligible complications in the management of distal femoral fractures. Both systems effectively reduce soft tissue injury.

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

Distal femur fractures present a substantial orthopedic challenge, necessitating a comprehensive exploration spanning epidemiology, anatomy, classification, diagnosis, and treatment strategies. This review thoroughly analyzes the multifaceted aspects surrounding distal femur fractures. It delves into the definition and epidemiology, shedding light on the incidence, age distribution, and associated risk factors. An exhaustive examination of the distal femur's anatomy, encompassing ligaments and tendons, establishes the groundwork for understanding fracture patterns and subsequent classification according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) system. Diagnostic considerations encompass physical examination and various imaging modalities, emphasizing the critical importance of prompt and accurate assessment. The extensive discussion on treatment options ranges from non-surgical management, including casting and traction, to surgical interventions, such as open reduction and internal fixation, intramedullary nailing, and external fixation. The implications for clinical practice underscore the necessity for tailored approaches based on fracture characteristics to optimize patient outcomes. However, this review also emphasizes areas necessitating further investigation, including exploring predictive biomarkers, advanced surgical techniques, and innovative rehabilitation protocols. Insights from long-term outcomes and quality-of-life assessments in diverse populations offer promising avenues for enhancing the comprehensive management of distal femur fractures. Continuous research in these areas can refine treatment strategies and elevate the standard of care for individuals grappling with this intricate orthopedic condition.

The linked nail/plate construct for the management of distal femur fractures in the elderly.

Distal femoral fractures represent a challenging injury, with many different factors such as the method of fixation, complexity of fracture pattern, and patient co-morbidities affecting the outcome. Lots of surgical treatment options have been described, but recently double construct fixation, using a nail/plate combination, has received lots of attention, a technique that leads to faster weight-bearing, low risk of metalwork failure, and non-union. The purpose of this study was to investigate the effectiveness of the linked nail/plate construct in the management of complex distal femur fractures and to investigate if the above technique leads to faster recovery and earlier radiographic union. In total 15 cases were included in the study, that underwent a combined nail/plate construct for a distal femur fracture between January 2021 and December 2022. Only cases with a linked nail/plate construct were included, with a minimum follow-up of 1 year. Open femur fractures, single implant fixation cases, and revision procedures were excluded. In this cohort study, 11 cases were periprosthetic distal femur features, and 4 cases were distal femur fractures around a native knee joint. The mean age group was 74 years, 86.6% of the patients had a BMI>25 and the mean time to fracture union was 24 weeks (range from 20 to 26 weeks). All cases healed uneventfully and the complication rate was 6.6%, including 1 case of superficial infection which resolved completely with oral antibiotics. The increasing age population, the complexity of distal femoral fractures along with the increasing physiological demands of the elderly population, drive the need for double fixation constructs that allow early mobilization and enhance fracture stability. In our study, the linked nail/plate construct seems to provide adequate stability and excellent union rates (100%) with no associated increased risk of complications.

Functional Outcome of Locking Compression Plate in Distal Femur Fractures

Introduction: Distal femur fracture is common in young people with high velocity injury. Management of distal femur fractures is a therapeutic challenge in orthopedics practice due to its extensive soft tissue injuries, bone loss, comminution, articular extension, instability.Open reduction with internal fixation replaces previous trend of closed conservative management and external fixation. Distal femoral locking compression plate (DF-LCP) requires both locking and compression screw fixation of the femur shaft. DF-LCP has been rapidly adopted as an alternative to intramedullary nails, blade plates and non-locking condylar screw.Materials and Methods: Prospective interventional study was done in department of orthopedics at National Medical College and Teaching Hospital, Birgunj for one year among 45 patients of age more than 18 years with post traumatic closed or open GA Type I, II distal femur fractures, AO Muller type A and C fractures. Ethical approval was obtained from institutional review committee and proper informed consent was taken. Type of implant used was DF-LCP.NEER’S scoring system was used for functional outcome.Results: Out of 45 patients, 42 patients with distal femur fracture were treated by DF-LCP.Three patients lostduring follow up hence removed from study. Out of 42 patients, mean age of the patients was 36.62 years. Most of them 31, (73.8%) were male. Predominant fracture was on right side 29 (69%).The study finding showed that 30 (71.4%) sustained injury due to road traffic accidents. Most of the patients 18 (42.9%) had type A2 fracture according to AO Muller distal femur fracture classification. Complications like surgical site infection observed in 3 cases. 100% union rate achieved with an average union time of 17.26 weeks. On evaluation according to Neer’s criteria mean score was 82.1 (Range: 48-96). Out of 42 patients 24 (57%) had excellent, 14 (33%) had good, 3 (7.2%) had fair and 1 (2.4%) had poor result.Conclusion: The study concluded DF-LCP is effective treatment for distal femur fracture. It provides stable construct for fracture union with excellent functional outcome.

Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail-Plate Construct.

Distal femoral fractures are a significant injury sustained by low- and high-energy trauma. Common treatment practices are lateral locking plate or intramedullary nail fixation, with disadvantages including risk of non and malunion and limited post-operative weightbearing status. Combining both techniques as a nail-plate construct (NPC) theoretically achieves enhanced fixation to allow immediate weightbearing. The aim of this study is to examine radiographic union, malunion and patient-reported outcomes in distal femur NPC fixation. Single-center retrospective study including all patients >18 years who sustained distal femur fractures treated with NPC. Primary outcomes were radiographic union, malunion and patient reported outcome measures at minimum 1-year follow-up. Secondary outcome measures included post-operative mobility, length of stay and complications. Relevant variables of normality are reported as mean with standard deviation. Subgroup analysis of patients aged <65 and ≥65 years are provided. Sixteen patients were included in the study. Rate of radiographic union was 100%. There was no case of malunion. All patients were allowed to bear full weight immediately post-operatively. Mean length of stay was 9.50 days, with 37.5% of patients discharged directly home. The majority (85.7%) of patients returned to pre-injury mobility. Early post-operative complications occurred in three patients. Three patients returned to theater. The mean EQ-5D-5L index value was 0.713, with 71.4% describing no problems with self-care and 85.7% reporting no or slight problems with usual daily activities. The NPC provided stable fixation permitting full weightbearing post-operatively with no cases of non or malunion. Return to pre-injury mobility and activity are encouraging. Based on these results we support the use of nail-plate construct fixation in the management of distal femur fractures.

Management of distal femoral fractures with metaphyseal and articular comminution (AO/OTA 33C) using nail and plate fixation: a technical note and case series of 14 patients.

To describe the surgical technique and the outcome of a case series of comminuted intra-articular distal femur fractures (AO/OTA 33C) treated with a nail-plate combination (NPC) implant. We retrospectively analyzed a case series of 14 patients with comminuted intra-articular distal femur fractures (DFF) treated with an intramedullary retrograde nail in combination with a lateral low-contact condylar locking plate, in a period between June 2020 and January 2023 at a Level 1 trauma center. Baseline demographic and clinical data were recorded. Time to bone healing, function using Schatzker Lambert Score, and complications were documented. Fourteen patients, 8 males and 6 females, with a total of 15 NPC implants, were included in this study. Eight out of 14 patients had open fractures, all with a Gustilo Anderson type IIIA exposure. The mean age was 48.5 ± 18.05years. The median follow-up was 392days, with only one patient lost to follow-up. 11 out of 15 implants achieved complete radiographic consolidation during follow-up, at a mean of 5.40 ± 1.07months. At the 12-month follow-up, all patients could fully bear weight painlessly or with mild pain. Schatzker Lambert Score was excellent for 4 patients, good for 2 patients, fair for 5 patients, and failure for 2 patients. The main postoperative complications were rigidity (3 cases), limb shortening (2 cases), and septic non-union (1 case). This study suggests that the nail-plate combination (NPC) may provide a more effective surgical technique for addressing the challenges associated with comminuted intra-articular distal femur fractures (AO/OTA 33C).

STUDY OF SUPRACONDYLAR FEMUR FRACTURE MANAGED SURGICALLY USING LOCKING COMPRESSION PLATE.

Background- Fractures of distal femur are one of the most prevalent fractures encountered in high-velocity trauma which are associated with high morbidity and mortality if not managed well. The isolated fracture can itself lead to complications such as Acute Respiratory Distress and pulmonary embolism. This neccesitaties early stabilisation of the fractures. Open reduction and internal xation (ORIF) with locking compression plate is the treatment of choice for closed fractures of the distal femur. Distal femur anatomic contoured locking compression plate (LCP) has shown to give one of the best results regarding recovery, fracture union, return to work and the functional outcome. We present our experience of management of distal femur fracture at our centre. Study Material and Methodsdone on 36 patients, (NEER'S Classication) age range of 18 to 70 years (irrespective of their sex), were subjected to xation by locking compression plate after obtaining thorough written informed consent. The observational study was carried at our institute between June 2021 to June 2022 Patients of both gender who were skeletally mature are taken into the study. In 61.5% of patients up to 50 years old and in Results40% of patients older than 50 years, the functional evaluation of LCP using Neers criteria was excellent. There was no statistically signicant (p&gt;0.05) difference in patients' functional status according to their age group who had distal femur fractures, which were stabilise by LCP. For supracondylar femur fractures, locking compression plates is a safe technique that has a good functional outcome, early clinical and radiographic union, and few complications

Functional and radiological outcome of surgical management of distal femur fracture with distal femoral locking plate at Chhindwara Institute of Medical Sciences: Chhindwara

Functional and radiological outcome of surgical management of distal femur fracture with distal femoral locking plate at Chhindwara Institute of Medical Sciences: Chhindwara

Double Plating Fixation vs Distal Femoral Replacement in the Management of Distal Femoral Fractures in Geriatric Patients.

Distal femur fractures are considered challenging to manage, particularly in geriatric patients. Double plating (DP) is a technique that helps with earlier rehabilitation and return to preinjury level of activity. Distal femoral replacement (DFR) is an alternative technique in the management of these fractures that may help to solve problems like associated knee osteoarthritis, osteoporosis, and severely comminuted condyles. The current study compares the functional and radiological outcomes of DFR and DP in the management of these fractures among geriatric patients. This randomized, comparative, interventional study was performed at a university hospital. A total of 30 patients who underwent DFR or DP after distal femur fractures (AO/OTA 33 A3, 33 C) were analyzed. The primary outcome was Knee Society Score (KSS), whereas secondary outcomes included postoperative complications rate, knee range of motion, reoperation rate, and operative time. No significant difference was observed between DFR and DP except for the knee component of the KSS at a 12-month interval (P= .03) and knee range of motion at a 12-month interval (P= .001), both of which were in favor of DP. No significant difference in postoperative complications (P= .06), reoperation rate (P= 1.00), or operative time (P= .06) was noted. DFR and DP had comparable functional (KSS) and radiological outcomes with no significant difference in postoperative complications, reoperation rate, or operative time.

EFFICACY AND SAFETY OF KNOTLESS BARBED SUTURES IN CAPSULAR CLOSURE FOLLOWING DISTAL FEMUR FRACTURE FIXATION.

Good wound closure is an important step in management of distal femur fracture to prevent infection and faster rehabilitation. Knotless barbed sutures can save time and distribute wound tension evenly. However, its role in terms of functional outcome, closure time, and postoperative complications has not been studied in a distal femur fracture. A total of 47 patients aged more than 18 years of distal femur fracture treated with distal femur locking plate were randomized either into either barbed or traditional suture groups. in the barbed group, capsular wound closure was carried out with 2-0 bidirectional barbed knotless sutures (Quill SRS® PDO, Angiotech, Vancouver, BC, Canada). In patients assigned to group B, capsular closure was done with 1-0 Vicryl® (Ethicon inc. Somerville, NJ) and 5-0 Ethibond® alternatively. The mean flexion at the knee joint was 105.7±15.6 degrees in the study group while it was 110.4±13.7 in the control group (p= 0.2133). Mean estimated closure time was significantly shorter in the study group as compared to the control group (p<0.05). Cases of needle prick injury were higher in traditional suture group. Patients developed stitch abscess and superficial infection in both groups. However, the difference in incidence between the two was not statistically significant. Barbed suture is an efficient method of wound closure. It reduces wound closure time with similar complication rate as with use of conventional sutures. Evidence Level II; Randomized Clinical Trial.

Outcomes of surgical management of closed periprosthetic distal femur fractures above total knee arthroplasties: A case series

Periprosthetic distal femur fractures present difficult treatment challenges and are expected to become more prevalent as the number of total knee arthroplasties (TKAs) continues to rise. The purpose of this study is to determine the functional outcomes and rate of re-operation following surgical treatment of closed distal femoral periprosthetic fractures above a TKA. We performed a retrospective review of 56 patients(45 females) who underwent surgical management of distal femur fractures (AO/OTA 33) above an ipsilateral TKA with a mean follow-up of 21 months (range, 12-78 months). Forty-three (77%) patients were treated with a lateral plate and screw construct, and 13 (23%) patients were treated with a retrograde intramedullary nail. There were 2 (4%) deep infections at a mean of 6 months (range, 5-7 months) post-operatively. At final follow-up, TKA components were retained in 53 (93%) patients, demonstrating a survivorship free of component revision following fracture treatment of 93% at 6.5 years. Survivorship free of any re-operation following fracture treatment was 86% at 6.5 years. Mean anatomic lateral distal femoral angle (aLDFA) was 84° (range, 72-89°) and mean anatomic posterior distal femoral angle (aPDFA) was 83° (range, 67-89°). There were 8 nonunions (14%) at 6 month follow-up, and no patients underwent a re-operation for malunion. This case series demonstrates increased revision rates and decreased survivorship of TKA components after surgical management of periprosthetic distal femur fractures. Surgeons must be aware of these potential complications when treating patients with periprosthetic distal femur fractures and counsel their patients appropriately. Therapeutic Level IV. See instructions for all others for a complete description of levels of evidence. • Closed distal femur fractures about a TKA demonstrate a high rate of non-union, 14% at 6-month follow-up. • Following this injury, patients experienced reduced mobility with only 82% being ambulatory after fixation, with 16% still wheelchair bound at 6 months after surgery. • As the number of annual TKA continues to rise, injuries involving those prosthetics will continue to rise.

Surgical outcomes of non-periprosthetic distal femur fragility fractures treated with a locking plate.

Management of distal femur fractures can be challenging, particularly in the aged female population. This retrospective study aims to analyze the surgical outcomes of aged female patients with non-periprosthetic distal femur fractures treated with a locking plate. This is an IRB approved retrospective review conducted at a level 1 trauma center. Fifty-five female patients (mean age of 71 years) with non-periprosthetic distal femur fractures underwent open reduction internal fixation using a locking plate from 2005 to 2019. The average follow-up time was 67 weeks from the date of injury. Criteria used for diagnosis of nonunion included one or more of the following: (I) three consecutive months without progression of healing on postoperative radiographs, (II) a total of nine months postoperative without complete healing, or (III) the physician diagnosed nonunion using clinical judgement. Outcome data was analyzed and compared amongst patients with and without obesity or diabetes. Statistical analysis was performed utilizing Microsoft Excel 2022 Data Analysis ToolPak with a standard statistically significant P value of <0.05. Thirty-two patients (58%) with distal femur fractures achieved union after initial treatment while 23 patients (42%) were diagnosed with nonunion. Fourteen patients (61%) underwent revision with 9 of these patients (64%) achieving union while 5 patients (36%) had persistent nonunion. Average healing time from initial treatment to union was 29 weeks, while average time from definitive treatment to union was 22 weeks. Obese patients [body mass index (BMI) >30 kg/m2] had a nonunion rate of 65%, while non-obese patients had a nonunion rate of 28%. Patients with diabetes had a nonunion rate of 65%, while patients without diabetes had a nonunion rate of 28%. Union can be successfully achieved in aged female patients with distal femur fractures treated with locking plates; however, the risks for nonunion and revision remain high. Patients with obesity and diabetes appear to be at an increased risk of nonunion (P=0.008 and 0.008, respectively). However, further research should be conducted with a prospective study or multivariate analysis and increased number of patients to reaffirm this data.

104 Our Management of Distal Femoral Comminuted Fractures with Femoral Defects

Abstract Aim Distal femoral fractures account for 3–6% of all femoral fractures. Current management of distal femoral fractures involve reducing bone fragments and placing a locking plate against it. In this study, the surgeon used a ‘selective approach’, whereby only key bone fragments in the comminuted fracture were reduced and fixed whilst the rest were either removed or left unreduced/unfixed. Method All patients underwent AxSOS plate/less invasive stabilisation system (LISS) surgery after adopting the “selective approach” during pre-surgical planning. A significant proportion of patients had a degree of bone defect, and most had open fractures. Primary outcomes included post-operative functional ability, quality of life assessed using EQ-5D-5L, Oxford Hip Score (OHS), Oxford Knee Score (OKS), range of movement. Results Average OKS and OHS for our cohort (n=10) is 23 and 35, respectively, with a mean knee-flexion of 86° (45°-120°). Average EQ-5D- 5L index value is 0.551; the most common response for mobility, self-care, usual activities, pain/discomfort, and anxiety/depression was moderate. 20% developed pin site infections, 40% reported significant knee stiffness. Conclusions Despite having a complex cohort where many of the patients had bone defects, and 80% had open fractures, the “selective approach” adopted in the present study achieved comparable outcomes to other studies with less-severe fracture characteristics, with similar operation times and range of knee-flexion. These results suggest that this alternative should be considered as a potential treatment option, although more studies on a similar cohort of patient to ours is needed to allow better comparison of the surgical approaches.

SP5.2.2 Our Management of Distal Femoral Comminuted Fractures with Femoral Defects

Abstract Aim Distal femoral fractures account for 3–6% of all femoral fractures. Current management of distal femoral fractures involve reducing bone fragments and placing a locking plate against it. In this study, the surgeon used a ‘selective approach’, whereby only key bone fragments in the comminuted fracture were reduced and fixed whilst the rest were either removed or left unreduced/unfixed. Method All patients underwent AxSOS plate/less invasive stabilisation system (LISS) surgery for their comminuted femoral fracture after adopting the “selective approach” during pre-surgical planning. A significant proportion of patients had a degree of bone defect, and most had open fractures. Primary outcomes included post-operative functional ability, quality of life assessed using EQ-5D-5L, Oxford Hip Score (OHS), Oxford Knee Score (OKS), range of movement. Results Average OKS and OHS for our cohort (n=10) is 23 and 35, respectively, with a mean knee-flexion of 86° (45°-120°). Average EQ-5D- 5L index value is 0.551; the most common response for mobility, self-care, usual activities, pain/discomfort, and anxiety/depression was moderate. 20% developed pin site infections, 40% reported significant knee stiffness. Conclusions Despite a complex cohort whereby many patients had bone defects, and 80% had open fractures, the “selective approach” adopted in the present study achieved comparable outcomes to other studies with less-severe fracture characteristics, with similar operation times and range of knee-flexion. These results suggest that this alternative should be considered as a treatment option, although more studies on a similar cohort of patient to ours is needed to allow better comparison of the surgical approaches.

Study to observe the functional outcome of surgical management of distal femur fractures using locking compression plate by minimally invasive plate osteosynthesis technique

Background: Fractures of the lower end of the femur are very tough to cure and linked to various consequences. Because of the high frequency of infection, non-union, and malunion, poor fixation, and a scarcity of appropriate equipment, implants, and antibiotics in the early 1960s, operational care of these fractures was avoided to a significant extent. Objective: The present study was undertaken to analyze the outcomes of fractures situated at the lower end of the femur, which is managed with CRIF. Materials and methods: A total of 20 patients were part of the study after obtaining the voluntary, written, informed consent. After collecting the basic demographic data, the clinical data were collected from all the participants. All participants underwent, a general clinical examination followed by a systemic examination. X-ray knee joint with distal femur AP and lateral views, CBC, FBG, LFT, RFT, and ECG were performed on all the participants. Results: Table 1 presents the gender distribution of the participants. The majority of the participants were males. Table 2 presents the age-wise distribution of the participants. The majority of the participants belonged to the age group of 21-30 years of age. Table 3 presents the type of injury of the patients.

Functional Outcome of Distal Femur Fracture Treated with Retrograde Nailing Technique

Background: Management of distal femur fractures is always challenging for the surgeons. Retrograde interlocking nailing is one of the effective methods with minimal complications for treatment of such fractures. The objective of the study was to evaluate the functional outcome of retrograde interlocking nailing technique in patients with distal femur fractures.&#x0D; Methodology: This interventional study was conducted at the department of orthopedic surgery, Liaquat University Hospital, Hyderabad from March 2017 to December 2019. Patients of either gender, between 30 to 65 years age, who presented with acute fracture of distal femur, as a result of trauma within 12-96 hours, requiring surgical intervention were included. Lysholm Scoring System was used to evaluate the functional outcome of patients treated with retrograde interlocking nailing technique. Data was analyzed using SPSS version 24.&#x0D; Results: Total 102 patients gave consent of participation. The mean age of study participants was 43.50±7.26 with the age range from 40-65 years. Male patients were 76.47% and female 23.53%. In majority (63.73%) of cases, mode of injury was road traffic accidents. Statistically significant difference in functional mobility score between the age groups and gender (p &lt; 0.05) was found. Statistically significant (p &lt; 0.05) decline in mean Lysholm score was observed in participants who had been bearing full weight for 3 months. Excellent functional outcome was achieved by 49.02% patients while 34.31% patients achieved good functional outcome.&#x0D; Conclusion: Retrograde interlocking nailing for fracture of distal femur is an effective fixation surgical technique with minimal complications and excellent to good functional outcome.&#x0D; Key words: Accidents, Femur Fractures, Fracture Fixation, Functional Performance

The effects of different cortical impingement scenarios on the biomechanical features of retrograde femoral nails in the management of distal femoral fractures: A finite element analysis.

The effects of different cortical impingement scenarios on the biomechanical features of retrograde femoral nails in the management of distal femoral fractures: A finite element analysis.

Potpourri – Recent and relevant literature in Distal Femur Fractures

Distal femur fractures include fractures of the supracondylar and intercondylar region and are relatively common injuries. The goals of treatment follow AO principles of anatomic reduction of the articular surface, restoration of limb alignment, length, and rotation. Despite improvements in implant design, management of distal femur fractures remains a challenge; fractures are often comminuted, intra-articular, and involve osteoporotic bone, making fixation challenging to achieve. In the geriatric trauma population, the incidence of co-morbidities is high and may impact the therapeutic options. We have aimed to bring together all the recent advances and literature in the management of distal femur fractures through this article