The Operative Treatment for the Fractures of Distal Femur

Kim, Sung Soo; Sohn, Sung Keun; Lee, Kyu Yeol; Park, Dong Man

Abstract

The management of distal femur fractures are difficult because of many complications including nonunion, delayed union, infection, loss of fixation, joint stiffness and angular deformity. Until 1960s, conservative management was considered superior to operative treatment in distal femur fracture. But, with advancement of new fixation devices and techniques, open reduction and internal fixation is recent trend. For the purpose of analyzing the factors effecting the results, we studied the 36 cases of distal femur fracture treated surgically from may, 1991 to May, 1994. By AO classification nineteen cases were type C fracture and seventeen cases were type A. According to Schatzker and Lambert criteria, excellent results were in 10 cases, good in 16, fair in 6 and fail in 4. We have analysed the results by fixation device, age, osteoporosis degree, fracture classification, open or closed fracture, operative approach in type C fracture and bone graft. Fair and fail results were more common in the cases of severe osteoporotic bone, type C with lateral approach and open fracture. Excellent and good results were more common in the cases of using the anatomical plate and dynamic condylar screw. We concluded that treatment device should be decided by fracture type, degree of communication, degree of osteoporosis and soft tissue state, and then satisfactory results will be obtained by accurate anatomical reduction, rigid internal fixation and early exercise.