Between 1980 and 1989, reports on 2,165 fractures of the distal part of the femur (1,051 women and 1,114 men) were collected by AO Documentation and are analyzed in the present paper. The number of fractures showed a bimodal pattern with a marked variation in the number of fractures in relation to gender and age. A larger prevalence of fractures was observed either in young men (about 20 years old, traffic or sport) and in old women (about 70, fall at home, osteoporosis).

The epidemiology of fractures of the distal femur.

Summary
Using national discharge and medical claims data, we studied the epidemiology of femoral fractures from 1996 to 2006. The annual hip fracture incidence declined from 600/100,000 to 400/100,000, without decline in the more rare femur fractures. Incidence rates for subtrochanteric and femoral shaft fractures were each below 20 per 100,000.

Fragility fractures of the hip and femur: incidence and patient characteristics

Background
Hip fractures in the elderly are associated with high 1-year mortality rates, but whether patients with other lower extremity fractures are exposed to a similar mortality risk is not clear.

Mortality After Distal Femur Fractures in Elderly Patients

The diversity of surgical options for the management of distal femoral fractures reflects the challenges inherent in these injuries. These fractures are frequently comminuted and intra-articular, and they often involve osteoporotic bone, which makes it difficult to reduce and hold them while maintaining joint function and overall limb alignment. Surgery has become the standard of care for displaced fractures and for patients who must obtain rapid return of knee function. The goal of surgical management is to promote early knee motion while restoring the articular surface, maintaining limb length and alignment, and preserving the soft-tissue envelope with a durable fixation that allows functional recovery during bone healing. A variety of surgical exposures, techniques, and implants has been developed to meet these objectives, including intramedullary nailing, screw fixation, and periarticular locked plating, possibly augmented with bone fillers. Recognition of the indications and applications of the principles of modern implants and techniques is fundamental in achieving optimal outcomes.

Distal femoral fractures: current concepts.

The literature lacks recent epidemiological studies on the incidence, trauma mechanism and fracture classification of distal femur fractures. The aim of the present study was to provide up-to-date information concerning the incidence of distal femur fractures in a large and complete population and to report on the distribution of fracture classification, trauma mechanisms and patient baseline demographics. The approach for this study was via a retrospective reviews of records. A total of 293 patients were treated for 302 distal femur fractures between 2005 and 2010. The mean age at the time of fracture was 62.2 years. The mean age was 44.0 years for males and 71.6 years for females. The gender distribution was 33.4% males and 66.6% females. The overall incidence of distal femur fractures was 8.7/100,000/year. After the age of 60 years, a rapid increase in the incidence of distal femoral fractures was observed in both genders, with a large female predominance. Low-energy injuries were the most common mode of injury in both genders (97%), with approximately 61% being the result of a fall from standing height. AO classification type A (extra-articular fractures) was the most common of all fractures (38.6%). Eighty-four patients (28.7%) were admitted with periprosthetic fractures, corresponding to an overall incidence of periprosthetic fractures of 2.4/100,000/year. The present study shows an incidence of 8.7/100,000/year of distal femur fractures. After the age of 60 years, a rapid increase in the incidence of distal femoral fractures was observed in both genders, with a considerable female predominance.

/pdf/population-based-epidemiology-and-incidence-of-distal-femur-1ua1e4gwzj.pdf

Population-based epidemiology and incidence of distal femur fractures

Summary Distal femoral fractures are rare and usually complex. Mostly, they are fixed with the Dynamic Condylar Screw (DCS) or the 95° condylar plate (CP). The simplicity of applying the DCS compared with the CP led us to investigate whether any possible mechanical deficiencies of the CP would detract from its technical advantages, thus limiting the indications for its use in the treatment of fractures of the distal femur. An in vitro investigation was carried out to measure the stability of a Y-osteotomy (with and without medial metaphyseal bone defect) stabilized either with the CP or the DCS. 8 pairs of human cadaveric femora classified according to their bone density were used. CP and DCS were applied to 1 bone in each pair by means of three lag screws (anterior, posterior and through the plate). Physiological loading was simulated and measurements were taken at the level of the osteotomy in the frontal and sagittal planes in order to assess rotational instability and the amount of gap opening in the vertical branch of the osteotomy. There was no relevant difference in the mechanical properties of the two fixations for fractures without medial defect, even if the stability of the fixation was reduced by removing the distal screw. Furthermore, interfragmental movement was minimal. In the frontal plane, simulated closure resulted in closure of the medial branch of the osteotomy in every case without any opening of the vertical branch of the osteotomy. In the sagittal plane, the closure of all branches of the osteotomy was confirmed for 11 bones and a rotation of the condyle was observed in 5 bones (3 CE 2 DCS). Removing the distal lag screw did not increase the instability. Even in osteoporotic bones, the DCS provided the same stability as the CP. For simple Y-osteotomies, the CP did not offer any technical or mechanical advantages. The stability in the frontal plane however was significantly reduced in osteotomies with medial defect. The amplitude of-interfragmental movement on all bones fixed by the CP, except for 1 pair, was greater than those fixed by the DCS. The absence of the anterior lag screw did not reduce stability. However, the absence of the lag screw within the implant considerably weakend the fixation- more so for the CP than for the DCS. Instability reached a maximum without any lag screw at all, which again was more pronounced for the CP than for the DCS. The Dynamic Condylar Screw (DCS) must be regarded as the implant of choice both technically and mechanically even in osteoporotic bones, but the distal condylar block must be at least 4 cm in length.

The mechanics of internal fixation of fractures of the distal femur: a comparison of the condylar screw (DCS) with the condylar plate (CP)

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The epidemiology of fractures of the distal femur.

The mechanics of internal fixation of fractures of the distal femur: a comparison of the condylar screw (DCS) with the condylar plate (CP)