The fracture of distal femur, which include the supracondylar region, intercondylar region and knee joint, have many problems by nature. It is almost all comminuted fracture and has a some difficulty in approach. Early attempts at internal fixation frequently gave unacceptably high rates of malunion, nonunion, and infection. Traditionally, nonsurgical treatment has been favored. Over the past 15 years, improved and meticulous techniques of internal fixation has been shown to yield good to excellent results. Also a number of excellent devices are now available.
We reviewed the patients who were admitted for fractures of the distal femur and were treated by the surgical treatments at department of Orthopaedic Surgery, Chungbuk National University Hospital from July 1993 through Augrst 1994. Fourteen cases were followed for more than one year. An average age at operation was 54 years (range, 18-74 years). The analysis group consisted of 9 males and 5 females. The cause of injuries were motor cycle injury in 8 cases, in-car accident in 2 cases, pedestrian injury in 2 cases and fall down in 2 cases. According to the classifications of AO, 4 cases were type Al, 2 were type A2, 2 were type A3, Cl was 1 case, C2 were 2 cases and C3 were 3 cases. Open fractures were 2 cases. Blade plate was used in 10 cases and DCS(dynamic compression screw) in 4 cases. With serial follow-up X-ray, ROM of knee and Neers scoring system, evaluation was performed. Excellent or good results were obtained in 13 cases (93%). Deep infection was developed in one case. At last follow-up, ROM was satisfactory.
Blad plate was very useful for severe osteoporotic patient. For comminuted, displaced intra-articular fractures such as Type C, extensile surgical approach was most useful.