title: Do elderly patients fare worse following operative treatment of distal femur fractures using modern techniques?
abstract: BACKGROUND
  The purpose of this study was to compare the functional outcomes and quality of life of older and younger patients with similarly treated distal femur fractures.
  
  
  METHODS
  We conducted an assessment of 57 patients who sustained distal femur fractures (Orthopaedic Trauma Association Type 33B, C) and underwent surgical treatment at our academic medical center. Patients were divided into 2 groups for analysis: an elderly cohort of patients aged 65 or older and a comparison cohort of patients younger than age of 65. A retrospective review of demographics, preoperative ambulatory status, radiographic data, and physical examination data was collected from the medical records. Follow-up functional data were collected via telephone at a mean of 2.5 years (range 6 months-8 years) using a Short Musculoskeletal Functional Assessment (SMFA). All patients underwent standard operative treatment of either nail or plate fixation.
  
  
  RESULTS
  There was no statistical difference in gender, fracture type, surgical technique, surgeon, or institution where the surgery was performed. The percentage of patients with healed fractures at 6-months follow-up was not significantly different between the cohorts. The elderly cohort had slightly worse knee range of motion at 3, 6, and 12 months postoperatively but there was not a statistically significant difference between the groups. The SMFA Daily Activity, Functional, and Bother indices were significantly worse in the older cohort (P < .01, P = .01, P = .02, respectively). However, there was no significant difference in the SMFA Emotional or Mobility indices.
  
  
  CONCLUSIONS
  Despite lower quality of life and functional scores, this study suggests that relatively good clinical outcomes can be achieved with surgical fixation of distal femoral fractures in the elderly patients. Age should not be used as a determinate in deciding against operative treatment of distal femur fractures in the elderly patients.
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery.
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Shulman
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery.
authors.forename: Bianka
authors.initials: B
authors.lastname: Patsalos-Fox
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lopez
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery ; Jamaica Hospital Medical Center, Department of Orthopaedic Surgery, Jamaica, NY, USA.
authors.forename: Sanjit R
authors.initials: SR
authors.lastname: Konda
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery.
authors.forename: Nirmal C
authors.initials: NC
authors.lastname: Tejwani
authors.affiliation: Hospital for Joint Diseases at NYU Langone Medical Center, Department of Orthopaedic Surgery ; Jamaica Hospital Medical Center, Department of Orthopaedic Surgery, Jamaica, NY, USA.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Egol
keywords: distal femur fracture; functional outcomes; geriatric trauma; lower extremity surgery; trauma surgery