Abstract
Introduction Distal femoral fractures (DFF) are a relevant problem for public health worldwide.
As the population ages, an increase in the rate of these lesions is expected in the
next few years.
Objective To describe the complications and mortality from DFF in geriatric patients.
Materials and Methods A descriptive and retrospective study with patients aged 60 years or older who underwent
surgery due to DFF. All subjects received treatment in the same trauma center from
2011 to 2015 and underwent a minimum follow-up of 1 year. Patients with incomplete
medical records were excluded. We analyzed demographics, radiological findings, local
and systemic complications, length of stay, and mortality rates.
Results In total, 16 patients met the inclusion criteria; their median age was of 72 (range:
61 to 93) years, and 14 subjects (87,5%) were female. The classification of the Association
for the Study of Internal Fixation (Arbeitsgemeinschaft für Osteosynthesefragen, AO,
in German) was as follows: A – 12 patients (75%); B – 2 patients (12.5%); and C –
2 patients (12.5%). There were no open fractures. The devices used in the operations
included dynamic condylar screw (DCS) plates (9 subjects; 56%), distal femur locking
compression plates (LCPs) (4 subjects; 25%), and retrograde distal femoral nails (DFNs)
(3 subjects; 19%). The median time until surgery was of 10 (range: 3 to 27) days,
with a median length of stay of 14 (range: 5 to 47) days. Complications were presented
by 6 (37.5%) patients: 2 (12.5%) cases of pulmonary thromboembolism and 4 (25%) cases
which required reintervention (2 due to hardware failure, 1 because of arthrofibrosis,
and 1 due to aseptic nonunion); there were no cases of infection. The mortality rate
at 12 months was of 0%.
Conclusion The patients with DFF in this geriatric cohort presented a long length of stay, with
a high rate of complications, including a rate of 25% of reintervention. Nevertheless,
the 1-year mortality rate was of 0%.
Keywords
distal femoral fractures - geriatric population - lenght of stay - mortality
