title: [Operative therapy of fractures of the distal femur. Predictive factors for a complicated course].
abstract: BACKGROUND
  Fractures of the distal femur are rare injuries that are mainly treated operatively. Complication rates remain high.
  
  
  OBJECTIVE
  This study aimed to analyse complications following the operative treatment of these fractures and to identify predictive factors that have the potential to identify patients who are at risk for a complicated course of treatment.
  
  
  METHODS
  We retrospectively analysed all fractures of the distal femur that were treated operatively at our institution between 2005 and 2015. Besides patient and fracture-specific data, surgical details and the types of complications that occurred were recorded and analysed.
  
  
  RESULTS
  Open soft tissue damage, the polytraumatised patient and the timing of surgery (i.e. emergency surgery) are significant risk factors for the development of a nonunion. A risk factor that predicts a postoperative infection is open soft tissue damage. Type C fractures, stabilisation as emergency surgery and an accompanying polytrauma are risk factors for a postoperative pneumonia.
  
  
  CONCLUSIONS
  The complication rate is significantly determined by surgical factors. To reduce the rate of nonunion, infection and pneumonia, the optimisation of the patient's general condition before surgery and optimal surgical care is more important than an immediate emergency surgery.
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland. sven.maerdian@charite.de.
authors.forename: S
authors.initials: S
authors.lastname: Märdian
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Rau
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Schwabe
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Tsitsilonis
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Simon
mesh_terms: D005264:Femoral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D007718:Knee Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011859:Radiography
keywords: Complications; Fractures of the femur; Operative therapy; Retrospective studies; Risk factors