title: Treatment Options for Distal Femur Fractures.
abstract: Despite advances in implant design, the management of distal femur fractures remains challenging. Fracture comminution and intra-articular extension can make it difficult to obtain an adequate reduction while preserving the soft tissue attachments to bone fragments to allow for bone healing. Many implant manufacturers have developed optimal anatomically contoured, distal femoral locking plates with percutaneous guides. This environment allows for the application of lateral locked plates in a biologically friendly manner. Although initial reports had high success rates, more recently a high rate of nonunion has been found, particularly in elderly patients. Limited literature is available for the treatment of patients with osteoporotic bone and associated ipsilateral total knee replacement and hip replacement. We present a patient with a distal femur fracture with significant comminution in the setting of an ipsilateral total hip replacement.
authors.affiliation: *Harvard Orthopaedic Trauma Initiative, Boston, MA; and †Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Arvind
authors.initials: A
authors.lastname: von Keudell
authors.forename: Kristin
authors.initials: K
authors.lastname: Shoji
authors.forename: Michael
authors.initials: M
authors.lastname: Nasr
authors.forename: Robert
authors.initials: R
authors.lastname: Lucas
authors.forename: Robert
authors.initials: R
authors.lastname: Dolan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Weaver
mesh_terms: D001860:Bone Plates; D019317:Evidence-Based Medicine; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D018579:Patient Selection; D011474:Prosthesis Design; D016896:Treatment Outcome