Modern Implant Options for the Treatment of Distal Femur Fractures.

J Am Acad Orthop Surg · Oct 01 2019 · Review

Hake ME, Davis ME, Perdue AM, Goulet JA

From the Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI

Orthopaedic Trauma

SUMMARY — THE REDUCTIONThis review compares locking plates, intramedullary nails, and distal femur replacement for distal femur fractures, noting unclear indications and notable nonunion/malunion complication rates.
Abstract, as published

Distal femur fractures occur in a periarticular fracture pattern and disproportionately afflict an aging population. Although the goals of treatment have not changed, the emergence of new surgical techniques and devices has recently been developed and refined to treat this challenging fracture pattern. Treatment options include open reduction and internal fixation with periarticular locking plates, intramedullary nails, or distal femur replacement. Despite rapid adoption, these modern solutions display a concerning complication rate, specifically from nonunion and malunion. The indications for each of these treatment strategies are not well defined and are the subject of current debate. As with the use of any orthopaedic implant, the knowledge of the strengths and weaknesses of each construct is paramount to successful treatment of these fractures. Recently, as the understanding of the biomechanics of distal femur fracture healing has improved, the literature has demonstrated clinical and theoretical improvements in the outcomes after distal femur fracture repair.

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