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The geriatric distal femur fracture: nail, plate or both?

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Abstract

Surgical fixation of distal femur fractures in geriatric patients is an evolving topic. Unlike hip fractures, treatment strategies for distal femur fractures are ill-defined and lack substantive high-quality evidence. With an increasing incidence and an association with significant morbidity and mortality, it is essential to understand existing treatment options and their supporting evidence. Current fixation methods include the use of either retrograde intramedullary nails, or plate and screw constructs. Due to the variability in fracture patterns, the unique anatomy of the distal femur, and the presence or absence or pre-existing implants, decision-making as to which method to use can be challenging. Recent literature has sought to describe the advantages and disadvantages of each, however, there is currently no consensus on a standard of care, and little randomized evidence is available that directly compares intramedullary nails with plating. Future randomized studies comparing intramedullary nails with plating constructs are necessary in order to develop a standard of care based on injury characteristics.

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The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

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  1. Orthopaedic Surgery Department, 1500 East Medical Center Drive, TC2912, SPC 5328, Ann Arbor, MI, 48109, USA

    Jenna L. Wilson, Mathieu Squires, Michael McHugh, Jaimo Ahn, Aaron Perdue & Mark Hake

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Correspondence to Jenna L. Wilson.

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Wilson, J.L., Squires, M., McHugh, M. et al. The geriatric distal femur fracture: nail, plate or both?. Eur J Orthop Surg Traumatol 33, 1485–1493 (2023). https://doi.org/10.1007/s00590-022-03337-5

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