Distal Femoral Fractures

Distal femoral fractures can be caused by high-energy or low-energy trauma. High-energy fractures are generally seen in young patients, these being comminuted, multiplanar, and intraarticular fractures. The low energy-induced fractures occur on osteoporotic bone, usually elderly, which results in comminuted and multiplanar fractures. An important issue is the fixation of these osteoporotic fractures. In most cases surgical treatment is recommended. Currently, there are two types of fixation: intramedullary nailing and locked supracondylar plates, with the possibility of percutaneous fixation. The implant to choose will depend on the type of fracture and the surgeon’s preference. Intraarticular distal femoral fractures are challenging both in osteoporotic bone and normal bone. Another issue is periprosthetic fractures of the distal femur after total knee arthroplasty. This is an increasingly clinical situation because of the large amount of total knee replacements that are done and is expected to increase in the near future. Fracture type with a stable prosthesis, the situation most common, and the medical conditions determine whether fixation is done with a plate or a retrograde intramedullary nail. Fractures of distal femur have a high complication rate, which is the reason to plan carefully these types of fractures before taking the patient to the operating room.