Revision ArthroplastyOpen Reduction vs Distal Femoral Replacement Arthroplasty for Comminuted Distal Femur Fractures in the Patients 70 Years and Older
Section snippets
Methods
After obtaining institutional review board approval, we performed a retrospective review of patients treated for distal femur fractures at our institution from 2007 to 2012. Patients were included if they were aged 70 years or older and had sustained a comminuted, intra-articular (AO/OTA classification 33C) distal femur fracture (Fig. 1). Exclusion criteria included an inability to ambulate before injury, fractures above a total knee arthroplasty, and the presence of bilateral injuries. Using
Results
A total of 229 patients underwent treatment for 230 distal femur fractures at our institution from 2007 to 2012. One patient died before treatment, and 33 fractures were treated nonoperatively. The remaining 196 fractures were classified according to the AO/OTA system, allowing the exclusion of 61 A-type and B-type fractures as well as 69 periprosthetic fractures. Twenty-eight of these remaining 66 total C-type fractures were then excluded as they occurred in patients younger than 70 years of
Discussion
Intra-articular distal femur fractures present operative challenges for physicians and result in significant morbidity for elderly patients. Prolonged periods of protected weight bearing, limited fixation secondary to poor bone stock, and increased risk of nonunion 12, 13, 14, 15 pose technical challenges. We retrospectively evaluated the experience at our institution treating comminuted, complete articular distal femur fractures in patients older than 70 years with either ORIF or DFR
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.06.006.