Abstract
Distal femur fractures can result from high-energy trauma in men under 30 years of age or from low-energy trauma in women over 75. Surgical fixation of distal femoral fractures has evolved to the point that non-operative treatment entails a higher risk of complications, which makes surgical intervention the treatment of choice in most of these fractures. The lateral approach to the distal femur allows for visualization, reduction and fixation of simple articular fractures. More complex fractures are better exposed with a lateral parapatellar approach (Krettek’s approach). Plate osteosynthesis is indicated in fractures of the distal femur Type 33-A, in particular in high comminution subgroups, and in case of Type 33-C according to the AO classification system. Evolving materials and design have enhanced plates reliability. Nevertheless, the surgical technique is extremely demanding, and even a mild inaccuracy may lead to an high rate of complications, down to complete synthesis failure. If articular involvement is identified at imaging, adequate surgical exposure and accurate reconstruction of the articular surface must be performed. Mininvasive techniques with biological saving of periosteal vascularization and lower soft tissue damage may promote bone consolidation and must be considered by the surgeon.
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Gli autori G. Incatasciato, O. Cammarata, G. Sallemi, R. Lupo, S.A. Rapisarda, G. Palmisciano ed E. Calamoneri dichiarano di non aver alcun conflitto d’interesse.
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Incatasciato, G., Cammarata, O., Sallemi, G. et al. Il trattamento con placche e viti delle fratture del terzo distale di femore. LO SCALPELLO 29, 75–80 (2015). https://doi.org/10.1007/s11639-015-0114-z
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DOI: https://doi.org/10.1007/s11639-015-0114-z