In This SectionTexas Health Research & Education Institute
Disease or Condition
Orthopedics / Fracture Repair
Mangement of fracture of the distal femur (Orthopedics / Fracture Repair)
Individuals sustaining a fracture of the distal femur will be operatively managed by one of two strategies. The first strategy involves fixation of the fracture with a reamed, interlocking intramedullary nail (Nail Group). The second treatment strategy involves open reduction and internal fixation of the fracture with a locking periarticular plate (Plate Group).
Fracture of the metaphyseal distal femur with or without intraarticular extension and with or without a TKA.
Fracture requiring operative treatment amenable to either IM nail or plate.
Surgeon agreed to randomize patient.
Informed consent obtained.
Patient is English speaking.
Fracture of the metaphyseal distal femur with intraarticular comminution.
Fracture with vascular injury (Gustillo Type IIIC injury) requiring repair.
Known metabolic bone disease.
Retained hardware or existing deformity in the affected limb that would complicate IM nailing or plating.
Symptomatic knee arthritis.
Soft tissue injuries compromising either treatment method with nail or plate.
Surgical delay greater than 3 weeks for closed fractures or 24 hours for open fractures.
Contralateral distal femur fractures (bilateral injury) or ipsilateral lower extremity injury that would compromise function of the knee .
Unable to comply with postoperative rehabilitation protocols or instructions (i.e. head injured or mentally impaired).