Internal Fixation of Geriatric Native Distal Femur Fractures: A Systematic Review

Abstract

Abstract Background Distal femur fractures account for 4-6% of osteoporosis related fractures of the femur in the elderly population. As life expectancy continues to increase, the population worldwide is ageing, and the number of individuals over 65 years of age is increasing and hence the incidence of distal femur fractures in elderly. Objectives management of geriatric distal femur fractures by surgical fixation whether locked plate or Retrograde intra medullary nail. Data Sources Data Sources: PubMed, Embase, and Cochrane databases were searched for English language articles up to April 24, 2022, identifying 2500 papers Study Selection studies discussing the outcomes and complications of post op fixation of distal femur either by locked plated, double plating, NP or RIMN Data Extraction one study provided Level III evidence, whereas the remaining 16 studies provided Level IV evidence. Studies were formally evaluated for methodological quality using established criteria. Treatment failure between groups was compared using an Odds rate ratio. Data Synthesis Treatment failure was defined for locked plating, double plating and RIMN for reasons such as mechanical failure, nonunion, deep and superficial infection, ROM and extensor mechanism disruption, revision surgeries. There were no significant differences in most of the outcomes and complication rates with some advantageous ROM in plates and lower infection in nails. Conclusions biological fixation overall provides lower complication rates with no significance between RIMN and locked plates in Extra articular fractures. no strong conclusions can be effectively made between the methods of fixations with both offering very good results overall, more prospective research with unified items for data resemblance across different studies should be made.