Evaluation of Operative Outcomes of Open Fractures of Distal Femur

Abstract

Introduction: Open fractures of the distal femur are a uncommon and intricate type of injury that typically occur
in individuals who have sustained multiple traumas. These types of fractures are often accompanied by bone loss,
contamination, damaged soft tissue, and a patient’s overall poor health condition. The purpose of this study is to
examine the outcomes of patients who were treated for open distal femur fractures using a staged protocol, which
involves initial external fixation with debridement, followed by definitive fixation using an anatomical locking
plate and bone grafting at a later stage.
Method: The study included a group of 20 patients of open distal femurfractures who were operated with
temporary external fixator and later on converted to definitive fixation with condylar locking plate with bone
grafting. These patients were operated with our staged protocol and clinical outcome was evaluated using the
functional evaluation scoring system by Sander’s et al and Knee Society Scoring. Out of these 20 patients, 1 was
lost to follow up at 3 months and 2 others were lost to follow up at 6 months. These 3 were excluded from our
study.
Results: Fracture union was seen in all 17 patients. The average time to union was 22.65+3.3 weeks. Two patients
were complicated with infection and delayed union. Ilizarov application was doneto achieve union and gain
length once the infection subsided.
Conclusion- Staged protocol of temporary external fixator followed by definitive fixation with condylar locking
plate and bone grafting is a safe and reliable method for the management of open distal femur fractures.