High-energy distal femur fractures: an update

Distal femur fractures follow a typical bimodal distribution between higher energy fractures affecting a younger population and lower energy fractures affecting a more elderly population. This article focuses on the former and the unique challenges they pose to the treating orthopaedic surgeon. Starting with initial assessment and early management there is discussion regarding appropriate investigation and classification of these injuries before moving on to discuss different techniques in their surgical management. These are complex injuries with potential for significant lifelong morbidity and as such the definitive management should be meticulously planned with appropriate input from experienced clinicians as well as other specialties and disciplines. There will and should be differences of opinion regarding ‘the best’ surgical technique for fixing these fractures, but the aim should be to restore pain-free function to the patient and limit the long-term sequelae of their injury.