Case presentation A 12-year-old boy with paraplegia due to neuromyelitis optica presented with progressive right knee pain and swelling. There was no history of trauma to the knee. [ncbi.nlm.nih.gov]

History patients commonly present after fall or traumatic event Symptoms common symptoms pain of distal femur that is made worse with knee movement inability to weight-bear Physical exam inspection tenderness, swelling, ecchymosis of the distal thigh [orthobullets.com]

There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. [scielo.br]

• Pain

  Advanced Search: • Use “ “ for phrases o [ “pediatric abdominal pain” ] • Use – to remove results with certain terms o [ “abdominal pain” –pediatric ] • Use OR to account for alternate terms o [teenager OR adolescent ] [msdmanuals.com]

  Pain Management Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster. [orthoinfo.aaos.org]

  Patients tend to experience sudden and severe pain along with bruising and swelling after this type of fracture. [orthosportandspine.com]

  Orthopedic Practice 56 Ernest Kwek and Richard E Buckley 9 Blood Transfusion 72 David W Sanders and Jeffrey L Carson... 171 Wound Infections 78 Wesley G Lackey Kyle J Jeray Atul F Kamath John G Horneff III and John L Esterhai Jr 20 Evaluation of the Painful [books.google.com]

• Weakness

  Bones can become very weak and fragile. A lower-force event, such as a fall from standing, can cause a distal femur fracture in an older person who has weak bones. [orthoinfo.aaos.org]

  These types of fractures occur most commonly in older people whose bones are weak. When they occur in younger patients it is often the result of a high-energy injury such as a car crash. [almuderis.com.au]

  In older people the most common cause is weak and fragile bone. Fractures of the knee can include the following: Distal femur fracture: The distal femur is part of the femur bone that flares out like the mouth of the funnel. [aokimd.com]

  Patients with osteoporosis, bone tumor or infections, or a history of knee replacement are more prone to distal femur fractures. In the elderly, even a simple fall from a standing position may result in a fracture as the bones tend to become weak and [oamortho.com]

• Surgical Procedure

  Despite the magnitude of the surgical procedure, all fractures healed, preserving the femoral length with the absence of infection and clinical complications. [ajol.info]

  A companion website contains the fully searchable text, an image bank, and videos of 25 surgical procedures. [books.google.com]

  This bedridden patient did not require other surgical procedures. [link.springer.com]

  MANAGEMENT Surgical reduction and fixation of displaced, intra- articular fractures of the distal femur is generally indicated.6 Nonsurgical management is reserved for nonambulatory patients or patients too frail to tolerate a surgical procedure. [journals.lww.com]

  Three patients developed knee stiffness (flexion <90°), two cases were resolved with joint manipulation under anesthesia and one refused to undergo subsequent surgical procedures. (Table 1) Table 1 Post-operative complications. [scielo.br]

• Severe Pain

  Symptoms Sudden, severe pain along with swelling and bruising are the predominant symptoms of distal femur fracture. The site is tender to touch with a visible physical deformity and shortening of the leg. [oamortho.com]

  Patients tend to experience sudden and severe pain along with bruising and swelling after this type of fracture. [orthosportandspine.com]

  Sudden, severe pain along with swelling and bruising are the predominant symptoms of femur fracture. The site is tender to touch with a visible physical deformity and shortening of the leg. [orthosports.ae]

  They have severe pain, swelling, and varying amounts of deformity above the knee. Patients may present with vascular and neurologic compromise. Diagnosis A thorough neurovascular exam is essential along with a spine and extremity exam. [orthopaedicsone.com]

  Traction may be useful for femoral shaft fractures because it counteracts the force of the muscle pulling the two separated parts together, and thus may decrease bleeding and pain. [10] Traction should not be used in femoral neck fractures or when there [en.wikipedia.org]

• Wound Infection

  Two patients developed superficial wound infection and one patient required medial plate removal after union due to deep infection. [ncbi.nlm.nih.gov]

  Arthritis 86 12 Perioperative Medical Management 93 14 119 Highly Crosslinked Polyethylene in Total 131 Thromboprophylaxis in Orthopedic Practice 56 Ernest Kwek and Richard E Buckley 9 Blood Transfusion 72 David W Sanders and Jeffrey L Carson... 171 Wound [books.google.com]

  No cases had iatrogenic neurovascular complications or deep wound infection; no cases were complicated by DVT or compartment syndrome; no cases developed reflex sympathetic dystrophy; no cases had implant failure until the last follow-up; and no cases [eoj.eg.net]

• Fracture

  In total 448 fractures were identified, of which Rorabeck type II was the most common fracture studied. The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). [ncbi.nlm.nih.gov]

  Plating in Lower Extremity Fractures 2,169 views November 2016 6 08:06 Atlanta Trauma Symposium 2016 Distal Femur Fractures FEATURING William Min 1,261 views August 2016 8 10:42 SICOT Fracture around the Knee - Introduction FEATURING Vilmos VECSEI 2,321 [vumedi.com]

  Pattern of femoral fractures and associated injuries in a Nigerian tertiary trauma centre. Niger J Clin Pract 2015;18(4):462–6. Batchelor E, Heal C, Haladyn JK, Drobetz H. Treatment of distal femur fractures in a regional Australian hospital. [jamc.ayubmed.edu.pk]

• Arthritis

  The most common complications of surgery include infection, knee stiffness, delayed bone healing, and knee arthritis. [aokimd.com]

  As the distal femur fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long term arthritis. [oamortho.com]

  11 Gouty Arthritis 86 12 Perioperative Medical Management 93 14 119 Highly Crosslinked Polyethylene in Total 131 Thromboprophylaxis in Orthopedic Practice 56 Ernest Kwek and Richard E Buckley 9 Blood Transfusion 72 David W Sanders and Jeffrey L Carson [books.google.com]

• Knee Pain

  Case presentation A 12-year-old boy with paraplegia due to neuromyelitis optica presented with progressive right knee pain and swelling. There was no history of trauma to the knee. [ncbi.nlm.nih.gov]

  The patient complains only of right knee pain with no radiation of pain. Her pain is exacerbated by palpation around the knee or any attempts at moving her right lower extremity. [aapc.com]

  A theoretically higher level of knee pain is a huge concern associated with RN [ 21 ]. [karger.com]

  Anterior knee pain in the retrograde group ( n = 14) was the main limiting factor in achieving better knee flexion even after 2 years. [oapublishinglondon.com]

• Contusion

  The presence and degree of contusion and swelling (as shown by the presence of skin wrinkles) should be noted. [teambone.com]

  Examination for ecchymosis, blisters, superficial abrasions, deep contusions, open fractures, or neurovascular insults that can occur in such injuries was done. [eoj.eg.net]

• Bone Pain

  The most common symptoms of compound distal femur fractures include: Break in the skin where you can see the bone Pain with weight bearing Swelling and bruising Tender to touch Physical deformity where the knee may look out of place and the leg may appear [almuderis.com.au]

• Blister

  Fracture blisters, representing seperation of the epidermis from the underlying dermis should be noted as clear versus hemorrhagic (denoting a deeper dermal injury which may not be safe to incise). [teambone.com]

  Eighteen patients with severe soft-tissue swelling and skin blistering were treated with temporary short-term external fixation and then underwent delayed open reduction and internal fixation. [link.springer.com]

  Examination for ecchymosis, blisters, superficial abrasions, deep contusions, open fractures, or neurovascular insults that can occur in such injuries was done. [eoj.eg.net]

• Delayed Wound Healing

  wound healing, flap necrosis and delayed healing of osteotomy [Table 4]. [ijoonline.com]

• Irritability

  […] fracture Medial parapatellar Complex medial femoral condyle fractures Posterior Very posterior Hoffa fragment fixation Midline incision over popliteal fossa Complications Complications of Distal femur fractures include the following: Nonunion Hardware irritation [boneandspine.com]

  […] synovitis Complications Knee pain/stiffness treatment early ROM physical therapy Symptomatic hardware risk factors lateral plate pain with knee flexion/extension due to IT band contact with the plate medial screw placement excessively long screws can irritate [orthobullets.com]

  Five patients who reported pain and tissue irritation after fracture union underwent hardware removal with a corresponding decrease in symptoms except for one case with patello-femoral joint pain. [link.springer.com]

  The combination of a stiff plate, stiff screws and fracture distraction leads to a result of nonunion.The size and contour of the plate may result in irritation of the iliotibial tract and may cause persistent pain. [oapublishinglondon.com]

• Peripheral Neuropathy

  This 76-year-old patient with a closed fracture (33-C2), affected by insulin-dependent diabetes and a severe peripheral neuropathy, had an early post-operative deep infection and opted for an above-the-knee amputation instead of limb salvage. [link.springer.com]

Assessment Initial Investigations should include: General workup including FBC and cross match, renal function, glucose, ECG and, if indicated, CXR, intravenous access with intravenous infusion if indicated. [patient.info]

Patients were taken up for surgery after routine preoperative workup. All the patients were operated within 10 days of the initial trauma. [ijoonline.com]

The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). [ncbi.nlm.nih.gov]

Patients with severe soft tissue damage underwent staged treatment, initiated by external fixation and followed by use of an internal fixator. All open fractures underwent staged treatment, with temporary transarticular external fixator. [scielo.br]

Complex Knee Fracture Management and Treatment Methods Feb. 27, 2017, 6 p.m. [vumedi.com]

Do Elderly Patients Fare Worse Following Operative Treatment of Distal Femur Fractures Using Modern Techniques? Geriatr Orthop Surg Rehabil 2014;5(1):27–30. [jamc.ayubmed.edu.pk]

Operative versus non-operative treatment. J Bone Joint Surg Br. 1996;78:110–114. 9. Stover M. Distal femoral fractures: current treatment, results and problems. Injury. 2001;32(suppl 3):SC3–SC13. 10. Zlowodzki M, Williamson S, Cole PA, et al. [journals.lww.com]

Moreover, there was no information on the prognosis of these injuries[3]. Hence, this system did not gain much popularity and is seldom used anywhere now among trauma surgeons worldwide. [traumainternational.co.in]

Severely comminuted fractures, poor bone quality, poor reduction, and poor fixation worsen the prognosis. Type C3 fractures are expected to develop significant secondary degenerative changes. Open fractures have a worse prognosis. [boneandspine.com]

The prognosis of knee function is directly related to surgical technique accuracy. REFERENCES 1. Arneson TJ, Melton LJ 3rd, Lewallen DG, O'Fallon WM. Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. [scielo.br]

Andhra Pradesh, India *Corresponding author Email: [email protected] Abstract Introduction In recent years, the treatment of distal femoral fractures has evolved although these fractures remain complex to treat and carry an inconsistent prognosis [oapublishinglondon.com]

[…] with malunion Q- subsequent encounter for open fracture type I or II with malunion R- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion S- sequela Distal Femur Fracture ICD-9 821.23(closed) 821.33(open) Distal Femur Fracture Etiology [eorif.com]

[…] accidents are more common in the younger population as compared with low-energy mechanisms such as fall from stand in the elderly and osteoporotic patients.2 Distal femoral fractures are often complex, intraarticular, and comminuted, irrespective of etiology [journals.lww.com]

/Sex/Age, y Etiology OTA AO Fracture Type Open/Closed Deformity During IM Nailing Technique Blocking Screw FU, mo Fracture Union Time, wk 1/M/28 Traffic accident, polytrauma 32 B2 Closed Varus at coronal plane Antegrade 1 to distal from medial side 24 [healio.com]

Coverage begins with a section on General Principles, including biomechanics, classification, epidemiology, principles of internal and external fixation, bone grafting, outcome studies, and imaging. [books.google.com]

[ 1 ] Kannus, P., Parkkari, J., Sievanen, H., et al. (1996) Epidemiology of Hip Fractures. [scirp.org]

The epidemiology of fractures of the distal femur. Injury 2000;31(3):C62–3. Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res 2011;469(4):1188–96. [jamc.ayubmed.edu.pk]

Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology. 1996 Nov. 7(6):612-8. [Medline]. Harrington KD. Orthopaedic management of extremity and pelvic lesions. [emedicine.medscape.com]

EPIDEMIOLOGY Kolmert and Wulff 2 analyzed the epidemiology of distal femoral fractures in Malmö, Sweden, in 1969–1976. [musculoskeletalkey.com]

Pathophysiology Diaphyseal fractures result from significant force transmitted from a direct blow or from indirect force transmitted at the knee. [3] Pathologic fractures may occur with relatively little force. [4] These may be the result of bone weakness [emedicine.medscape.com]

Epidemiology Incidence Common 3-6% of femur fractures <1% of all fractures Demographics bimodal distribution young healthy males elderly osteopenic females Pathophysiology Mechanism young patients high energy with significant displacement older patients [orthobullets.com]

[…] distal fractures, the knee must be flexed and a distal femoral traction pin must be inserted; - flexed knee position releaxes the posterior knee capsule and the gastrocnemius muscle, thereby avoiding a hyperextension deformity at the fracture, which can prevent [wheelessonline.com]

We thought we have used it as a reduction screw but it acted as a lag screw, preventing motion at the fracture site. Given this analysis, we have only taken the lag screw out to make the construct less stable. [ncbi.nlm.nih.gov]

Newer techniques and implants may help prevent this risk, but cannot eliminate it entirely. Your commitment to your recovery. [orthoinfo.aaos.org]

It only considered definitive treatment for patients with significant comorbidities that contraindicate surgical management. [13] External fixators [ edit ] External fixators can be used to prevent further damage to the leg until the patient is stable [en.wikipedia.org]