Background: Distal femur fractures are relatively rare injuries that usually require surgical treatment. Angular-stable plates allowing for anatomical repositioning and stable fixation of splinters, particularly in articular fractures, are commonly used in such cases. The goal of the study was to analyze the outcomes of the surgical treatment of high-energy articular fractures of distal femur.
Material And Methods: The study included 22 patients treated in years 2007-2013. The average follow-up period was 39.5 months. The range of knee motion was recorded during follow-up visits. Treatment outcomes are presented using the Prichett's criteria as well as using IKDC and KOOS scores. Bone union and lower limb axial deformity were assessed using X-ray images.
Results: The average range of motion was 0-99 degrees. According to Prichett's criteria, a total of 54% good and very good results as well as 36% of satisfactory results were recorded. The average IKDC score was 59.4 points while the average KOOS score was 54.7 points Bone union was achieved in 91.6% of fractures. Axial deformity was rare, and correlation between the valgus angle and the clinical and functional outcomes was observed.
Conclusions: The applied methods for internal fixation afforded satisfactory treatment outcomes in most patients with high-energy distal femur fractures. No significant reduction in the mobility of the affected knee or axial deformation are observed after proper repositioning of distal femur fracture splinters using an angular-stable plate.
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Knee
December 2024
Orthopedic Surgery and Traumatology, Hospital Clínic de Barcelona, Barcelona, Spain.
Distal femoral replacement (DFR) with megaprostheses is a salvage revision total knee arthroplasty (rTKA) procedure indicated in cases with massive bone defects in the distal femur. As long as these implants achieve fixation only in the diaphysis, the high aseptic loosening rate reported in some series is probably related to a lack of rotational stability. Two patients with extensive distal femoral bone defects with preservation of the metaphyseal-diaphyseal junction underwent rTKA.
View Article and Find Full Text PDFJ Hand Microsurg
January 2025
Orthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste, Italy.
Background: Aim of the present paper is to report the preliminary results of CAD-CAM (Computer-Aided Design - Computer-Aided Manufacturing) technology application to distal femur nonunion treatment with free fibula flap, custom made medial plating and maintenance of a stable lateral locking plate.
Methods: Two cases of distal femur nonunion that occurred after lateral locking plating were treated and prospectively followed-up. Surgical planning followed the same preoperative protocol adopted for mandibular CAD-CAM reconstruction.
The current study aimed to objectively evaluate the fit of a rectangular, tapered stem to the severely dysplastic hips on the basis of the proximal femoral anatomy and the dimensional properties of the stem. It was hypothesized that the stem size planned with accordance to the diaphyseal canal width alone can accommodate the distal femur successfully with no sizing mismatch. Forty-six patients (53 hips) suffering from secondary osteoarthritis due to hip dysplasia scheduled for total hip arthroplasty (THA) with a subtrochanteric transverse shortening osteotomy were included.
View Article and Find Full Text PDFKnee
January 2025
Department of Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Background: Long-leg alignment and joint line obliquity have traditionally been assessed using two-dimensional (2D) radiography, but the accuracy of this measurement has remained unclear. This study aimed to evaluate the accuracy of 2D measurements of lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) using upright three-dimensional (3D) computed tomography (CT).
Methods: This study involved 66 knees from 38 patients (34 women, four men) with knee osteoarthritis (OA), categorized by Kellgren-Lawrence (KL) grade.
Injury
January 2025
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark.
Background: Proximal femoral fractures has been associated with high mortality risk, while little is known about more distal lower extremity fractures. The aim was to report 30- and 365-days mortality in surgically treated lower extremity fractures in individuals above 65 years.
Materials And Methods: We extracted data from the Danish National Patient Register on all surgically treated lower extremity fracture in the period 1998-2017.
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