Fixation Vs Arthroplasty for Management of Geriatric Distal Femur Fractures

Abstract

Abstract Background Distal femur fractures are considered challenging to manage, particularly in geriatric patients. Double plating (DP) is a technique that helps with earlier rehabilitation and return to pre-injury level of activity. Distal femoral replacement (DFR) is an alternative technique in the management of these fractures that may help to solve problems like associated knee osteoarthritis, osteoporosis, and severely comminuted condyles. The current study compares the functional and radiological outcomes of DFR and DP in the management of these fracture among geriatric patients. Methods This randomized, comparative, interventional study was performed at a university hospital. A total of 30 patients who underwent DFR or DP after distal femur fractures (AO/OTA 33 A3, 33 C) were analyzed. The primary outcome was Knee Society Score (KSS), whereas secondary outcomes included postoperative complications rate, knee range of motion (ROM), reoperation rate, and operative time. Results No significant difference was observed between DFR and DP except for the knee component of the KSS at 12-month interval (p = 0.03), and knee ROM at 12-month interval (p = 0.001), both of which were in favor of DP. No significant difference in postoperative complications (p = 0.06), reoperation rate (p = 1.00), or operative time (p = 0.06) were noted. Conclusion DFR and DP had comparable functional (KSS) and radiological outcomes with no significant difference in postoperative complications, reoperation rate, or operative time.