Assisting technical development in closed reduction for distal femoral fractures

Distal femoral fracture is one of the difficult fractures to treat due to the complex types and varies complications after operation. The concept about closed reduction to deal with fracture has been accepted widely with the innovation of surgical technology and internal fixation. Some tissue, including joint capsule, ligaments, muscles and tendons, surround femoral condyle, which indicates they may tract the fractured bone to deformity. In addition, the difficulty of reduction during operation may be increased with combined other injuries. At present, the idea of using different methods to reduce the re-injury before the closed reduction of distal femoral fracture has been recognized and popularized. A kind of appropriate reduction and internal fixation can not only reduce the difficulty of operation but also shorten the operation duration and reduce the incidence of postoperative complications. In addition to the common reduction method of manual reduction, plate can not only be taken as internal fixation, but also achieve reduction reviewing literatures about the methods of reduction in recent years. However, it is not suitable for some complex fractures. The traction table is not widely used at present due to varies complications. Distractors like AO distractor or other kinds of femoral distractors can achieve reduction by providing reverse force. However, it should be noticed that some risk factors such as vascular and nerve injury can occur during the surgery. The present study summarized different ways that were adopted during the closed reduction and internal fixation of distal femoral fractures. The appropriate method chose by surgeons to improve the efficiency and reduce risks should be used based on the need of surgery.