Abstract
Fractures of the distal femur were studied in twenty patients treated at Hamanomachi General Hospital, consisting of eight males and twelve females with a mean age of 59.3 years (range, 13 to 83 years). The average duration of follow-up study was 1.5 years (range; 0.4 to 9.5 years). All patients were classified according to the AO/ASIF classification and Kuwano's criteria was used for the assessment of the results.
There were twelve cases of type A, three of type B, and five of type C.
Type A: Closed treatment consisting of skeletal traction or a plaster cast was performed on four patients. Internal fixation was used in eight patients: Kirschner wires (K-wire) in one, Zickel nail in five, Intramedullary Supracondylar nail (IMSC nail) in one, and May anatomical bone plate in one. Results were excellent in six, good in four, and fair in two. Perfect anatomical reduction was not necessary, while correction of the axial alignment, length and rotation were necessary. Closed treatment or intramedullary fixation is thought to be preferable.
Type B: Open reduction and internal fixation were performed on all patients using K-wire, Herbert screw or cannulated screw with good to excellent results. An accurate anatomical reduction of the joint surface and early motion exercise is essential.
Type C: Internal fixation was performed in four patients: K-wire or Tibia bolts in three, and IMSC nail in one with excellent results. Closed treatment was done on one patient who had hemophilic arthropathy with fair result. Open anatomical reduction of the joint surface and internal fixation are thought to be preferable. And early motion exercise is necessary.
We conclude that selecting the appropriate treatment for each case is important.
