Distal femur fractures management and evolution in the last century.

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Abstract

[Indexed for MEDLINE] 3. Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1485-1493. doi: 10.1007/s00590-022-03337-5. Epub 2022 Jul 27. The geriatric distal femur fracture: nail, plate or both? Wilson JL(1), Squires M(2), McHugh M(2), Ahn J(2), Perdue A(2), Hake M(2). Author information: (1)Orthopaedic Surgery Department, 1500 East Medical Center Drive, TC2912, SPC 5328, Ann Arbor, MI, 48109, USA. wijenna@med.umich.edu. (2)Orthopaedic Surgery Department, 1500 East Medical Center Drive, TC2912, SPC 5328, Ann Arbor, MI, 48109, USA. Surgical fixation of distal femur fractures in geriatric patients is an evolving topic. Unlike hip fractures, treatment strategies for distal femur fractures are ill-defined and lack substantive high-quality evidence. With an increasing incidence and an association with significant morbidity and mortality, it is essential to understand existing treatment options and their supporting evidence. Current fixation methods include the use of either retrograde intramedullary nails, or plate and screw constructs. Due to the variability in fracture patterns, the unique anatomy of the distal femur, and the presence or absence or pre-existing implants, decision-making as to which method to use can be challenging. Recent literature has sought to describe the advantages and disadvantages of each, however, there is currently no consensus on a standard of care, and little randomized evidence is available that directly compares intramedullary nails with plating. Future randomized studies comparing intramedullary nails with plating constructs are necessary in order to develop a standard of care based on injury characteristics. © 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature. DOI: 10.1007/s00590-022-03337-5