Distal femur fracture

Question 1

Classification

Answer 1

Type A - extra-articular Type B - partial articular

Type C - complete articular

Question 2

Clinical Features

Answer 2

Pain at knee and distal thigh
Unable to weight bear

Obvious deformity
Swelling and ecchymosis
Knee effusion - if intra - articular

Question 3

Investigations

Answer 3

ATLS

Urgent bloods including coagulation, Group and Save, X mismatch

If pathological - calcium and myeloma screen

Xray - AP and lateral of knee and entire femur

Intra - articular - CT

Question 4

Mx

Answer 4

ATLS 
Analgesia 
Closed reduction - with analgesia 
Immobilise using skin traction 
Fixation

Question 5

Fixation

Answer 5

proximal extra-articular fractures or simple intra-articular fractures - retrograde nailing

or

Distal fractures or complex intra-articular fractures -
Open reduction internal fixation (ORIF) - distal femoral plate

Question 6

Complications

Answer 6

Mal union
Non union
OA