Distal femur fractures: The use of a fibular strut allograft with dual locking plates allows for early weight bearing.

Abstract

Introduction: Distal femur fractures result in high morbidity and mortality - comparable to that of hip fractures. The commonly used surgical fixation techniques today, locked plating and intramedullary nailing, have shown high postoperative complication rates. Thus, many surgeons temporarily keep patients non-weight bearing in the early postoperative stage. Increased time to ambulation after surgery is known to increase systemic complications in patients. We aim to investigate if an augmented fixation technique involving the use of a fibular strut allograft with dual locking plates helps to allow early mobilization postoperatively without adverse outcomes.

Methods: Five geriatric patients (four female, one male) with distal femur fractures (native or periprosthetic) were treated in our institution with the aforementioned technique, and were allowed early postoperative weight-bearing. These patients were followed up for postoperative outcomes. The primary outcomes studied were non union, implant failure and wound complications. Secondary outcomes studied include time to union, and Sander's functional score.

Results: There were no cases of non-union, implant failure or wound related infection. All patients achieved radiological union (mean = 12.6 weeks). Using Sander's functional scoring, two patients achieved excellent, two achieved good and one had fair outcomes. All patients were followed up for at least 6 months after operation.

Conclusion: Our method of augmented fixation with fibular strut allografts potentially allows for early weight bearing without adverse outcomes. Further studies with larger sample sizes are required to validate our findings.