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The Distal Femur Fractures

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Intraarticular Fractures

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Abstract

Distal femoral fractures should be treated without disturbing knee or lower extremity function. Therefore, it is important to consider all treatment options according to the patient’s age, fracture type, level of adjacent soft tissue injuries, and risk of complications. For many years, nonsurgical treatment was the gold standard. More recently, internal fixation has produced improved clinical outcomes. Another benefit of surgical management is the possibility of early functional rehabilitation training.

A locking compression plate is applicable for both young and older patients to achieve joint surface reduction and articular cartilage preservation. On the other hand, the retrograde intramedullary nail would be the primary choice for middle-aged and elderly people as this method is less invasive and can achieve axial stability, thereby allowing for early partial weight-bearing.

Although arthroscopic treatments are difficult for these distal femoral fractures, arthroscopy-assisted reduction and internal fixation should be applied especially for Hoffa fractures.

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References

  • Arastu MH, Kokke MC, Duffy PJ, Korley RE, Buckley RE (2013) Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. Bone Joint J 95-B(9):1165–1171

    Article  CAS  Google Scholar 

  • Butt MS, Krickler SJ, Ali MS (1996) Displaced fractures of distal femur in elderly patients: operative versus non-operative treatment. J Bone Joint Surg Br 78:110–114

    Google Scholar 

  • Demirel M, Dereboy F, Ozturk A (2006) Arthroscopically assisted intra-articular lateral femoral condyle fracture surgery. Arthroscopy 22:690e1–690e4

    Article  Google Scholar 

  • Ercin E, Bilgili MG, Basaran SH et al (2013) Arthroscopic treatment of medial femoral condylar coronal fractures and nonunions. Arthrosc Tech 2:e413–e415

    Article  Google Scholar 

  • Goel A, Sabat D, Agrawal P (2016) Arthroscopic-assisted fixation of Hoffa fracture: a case report and description of technique. J Clin Orthop Trauma 7:61–65

    Article  Google Scholar 

  • Griffin XL, Parsons N, Zbaeda MM, McArthur J (2015) Interventions for treating fractures of the distal femur in adults. Cochrane Database Syst Rev 8:CD010606

    Google Scholar 

  • Heiney JP, Barnett MD, Vrabec GA, Schoenfeld AJ, Baji A, Njus GO (2009) Distal femoral fixation: a biomechanical comparison of trigen retrograde intramedullary (i.m.) nail, dynamic condylar screw (DCS), and locking compression plate (LCP) condylar plate. J Trauma 66:443–449

    Article  Google Scholar 

  • Hierholzer C, von Rüden C, Pötzel T, Woltmann A, Bühren V (2011) Outcome anal-ysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: a retrospective analysis. Indian J Orthop 45:243–250

    Article  Google Scholar 

  • Hoffa A (1904) Lehrbuch der Frakturen und Luxationen, 4th edn. Ferdinand Enke-Verlag, Stuttgart, pp 453

    Google Scholar 

  • Kregor PJ, Stannard JA, Zlowodzki M, Cole PA (2004) Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma 18:509–520

    Article  Google Scholar 

  • Lal H, Bansal P, Khare R, Mittal D (2011) Conjoint bicondylar Hoffa fracture in a child: a rare variant treated by minimally invasive approach. J Orthop Traumatol 12:111–114

    Article  Google Scholar 

  • Leung KS, Shen WY, So WS, Mui LT, Grosse A (1991) Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. J Bone Joint Surg Am 73:332–340

    Article  CAS  Google Scholar 

  • Markmiller M, Konrad G, Sudkamp N (2004) Femur-LISS and distal femoral nail for fixation of distal femoral fractures: are there differences in outcome and complications? Clin Orthop Relat Res 426:252–257

    Article  Google Scholar 

  • Marsh JL, Slongo TF, Agel J et al (2007) Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma 21(10 Suppl):S1–S133

    Article  CAS  Google Scholar 

  • McCarthy JJ, Parker RD (1996) Arthroscopic reduction and internal fixation of a displaced intraarticular lateral femoral condyle fracture of the knee. Arthroscopy 12:224–227

    Article  CAS  Google Scholar 

  • Mooney V, Nickel VL, Harvey JP, Snelson R (1970) Cast-brace treatment for fractures of the distal part of the femur: a prospective controlled study of one hundred and fifty patients. J Bone Joint Surg Am 52:1563–1578

    Article  CAS  Google Scholar 

  • Papadopoulos AX, Panagopoulos A, Karageorgos A, Tyllianakis M (2004) Operative treatment of unilateral bicondylar Hoffa fractures. J Orthop Trauma 18:119–122

    Article  Google Scholar 

  • Piétu G, Ehlinger M (2017) Minimally invasive internal fixation of distal femur fractures. Orthop Traumatol Surg Res 103(1S):S161–S169

    Article  Google Scholar 

  • Schütz M, Müller M, Regazzoni P, Höntzsch D, Krettek C, Van der Werken C et al (2005) Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Arch Orthop Trauma Surg 125:102–108

    Article  Google Scholar 

  • Smillie IS (1978) In: Smillie IS (ed) Injuries of the knee joint, 5th edn. Churchill Livingstone, New York

    Google Scholar 

  • Stern RE (1996) Comment. Arthroscopy 12:760–761

    Article  CAS  Google Scholar 

  • Tornetta P III, Egol KA, Jones CB, Mullis B, Collinge CA, Ostrum RF (2013) Locked plating vs. retrograde nailing for distal femur fractures: a multicenter randomized trial. In: Proceedings of the Orthopaedic Trauma Association Annual Meeting, October 9–12, Phoenix, AZ, USA

    Google Scholar 

  • Wallenbock E, Ledinski C (1993) Indications and limits of arthroscopic management of intraarticular fractures of the knee joint. Aktuelle Traumatol 23:97–101

    CAS  PubMed  Google Scholar 

  • Zeebregts CJ, Zimmerman KW, Ten Duis HJ (2000) Operative treatment of a unilateral bicondylar fracture of the femur. Acta Chir Belg 100:1104–1106

    Google Scholar 

  • Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ (2006) Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005). J Orthop Trauma 20:366–371

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Chugoku Rousai Hospital, Kure, Hiroshima, Japan

    Yoshiaki Sasashige & Eisaku Fujimoto

  2. Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan

    Nobuo Adachi & Mitsuo Ochi

Authors
  1. Yoshiaki Sasashige
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  2. Eisaku Fujimoto
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  3. Nobuo Adachi
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  4. Mitsuo Ochi
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Corresponding author

Correspondence to Yoshiaki Sasashige .

Editor information

Editors and Affiliations

  1. Department of Orthopedics and Traumatology, T.C. Ufuk University, Ankara, Turkey

    Mahmut Nedim Doral

  2. Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden

    Jón Karlsson

  3. Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA

    John Nyland

  4. Helfentalweg 1A, Landeskrankenhaus Feldkirch Abt. Unfallchirurgie, Innsbruck, Austria

    Karl Peter Benedetto

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Sasashige, Y., Fujimoto, E., Adachi, N., Ochi, M. (2019). The Distal Femur Fractures. In: Doral, M., Karlsson, J., Nyland, J., Benedetto, K. (eds) Intraarticular Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-97602-0_28

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  • DOI: https://doi.org/10.1007/978-3-319-97602-0_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97600-6

  • Online ISBN: 978-3-319-97602-0

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