A Study on Various Approaches of Functional Outcome of Distal Femur Fractures

Abstract

The usual mechanism of injury is high energy trauma, more often a road traffic accident (RTA) in a younger population and a domestic accident, more often a fall in elderly people. Distal femoral fractures are reported to have high morbidity and mortality associated with them. Many studies have recommended, through radiological examination, including evaluation by CT scan, considering the high proportion of distal femur fractures involving intraarticular surface, apart from routine clinical examination. As high as 55% of the distal femur fractures are reported to involve intra-articular surface.Fractures of the distal femur are relatively rare but are said to have severe consequences. The reported frequency of distal femur fractures among overall fractures is about 0.4%, and they constitute about 3% of femoral fractures. Many studies have also advised that the presence of pulsation may mislead the clinician, as it is a poor indicator of the absence of vascular injury and have recommended proper tests to rule out this serious associated injury. A femoral nerve block is indicated and recommended by the same authors in the emergency room. Various internal fixation methods have evolved over the last few decades and are in clinical practice to target distal femur fractures. Many prospective studies have been conducted in western countries to assess the long term functional outcomes of many of these techniques. But the amount of literature published on the subject relatively less from developing countries like India. Since the outcomes may heavily depend on the population characteristics, the technical skill of the surgeons and the support therapy in the preoperative period, it is the need of the hour to generate evidence specific to a particular setting, to guide future clinical decisions.