Current concepts in distal femur fractures treatment

Abstract

The aim: Presenting the methods of evaluation and surgical treatment of patients with distal femur fractures treated in Orthopedics and Traumatology Clinic "V. Bețișor" during 2010-2015 years. Materials and methods: There were analyzed 120 clinical cases with 123 distal femur fractures (3 patients were with bilateral fractures); men - 58 (48.3%) and women - 62 (51.7%) aged between 17 and 90 years, (mean age 53,4 years). Trauma circumstances: traffic accident - 40 cases, habitual trauma - 71, precipitation – 7, industrial – 1, by firearm - 1. Fractures were classified as AO: type A1 – 13 cases, type A2 – 29 cases, type A3 – 39 cases, type B1 – 2 cases, type B2 – 1 case, type C1 – 7 cases, type C2 – 27 cases and type C3 – 5 cases. The definitive osteosynthesis was performed at the period of 0-52 days with an average of 12,4 days. There were used surgical approaches: classical antero-lateral – 52, MIPO – 35, MIPPO – 1, TARPO – 16 and medial parapatelar (for retronail) – 19 cases. Fixators used: condylar butress plate–24, blade–plate 95o – 11, angular stability plate – 65, locked intramedullary nail (retronail) – 18, DCS – 2, screws (for type B fractures ) – 3. Results: Consolidation occurred in 94% of cases in a period of from 4 to 9 months. There were 3 cases of deterioration of fixators, solved with osteoplastic re-osteosynthesis; 3 secundary displacements with further vicious consolidation, 4 pseudoarthrosis and 2 septic complications. Conclusions: Individual approach of the distal femur fractures, respecting the AO principles,the right choice of implant and minimally invasive surgical techniques is a optimal tactics to obtain favorable functional results and avoid complications.