Fractures of the distal femur, even those with articular extension, are well suited to surgical fixation with modern precontoured anatomic plates and nails. Numerous adjuvant techniques are available to the treating surgeon to obtain and maintain reduction while preserving fracture biology. Yet despite their proven track record and benefits over older implants, technical errors are common and must be overcome with proper preoperative planning and intraoperative attention to detail. This review summarizes the current state of the art regarding distal femur fractures, with an emphasis on relevant modern plate and nail surgical techniques, tempered by our current understanding of implant biomechanics, fracture healing, and long-term outcomes.
*Department of Orthopaedics and Rehabilitation, San Antonio Military Medical Center, Fort Sam Houston, TX;
†Orthopaedic Specialty Associates, Fort Worth, TX; and
‡University of Texas Health Science Center, Houston, TX.
Reprints: Michael J. Beltran, MD, Uniformed Services University for the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 (e-mail: email@example.com).
C. A. Collinge is a paid consultant for Biomet Trauma, Smith and Nephew, and Stryker, receives royalties for intramedullary nailing products from Biomet Trauma and Advanced Orthopaedic Systems, is an editor for the Journal of Orthopaedic Trauma, and teaches courses for AO North America and Stryker. J. L. Gary teaches courses for AO North America, is a paid consultant for Smith and Nephew by teaching courses, and owns stocks in RTG Scientific. The other author reports no conflict of interest.
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Accepted January 22, 2015