Abstract
Background
Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. Currently this cohort is not afforded the same resources as those with hip fractures. This study aims to compare their mortality rates and assess whether surgical intervention improves either outcome or mortality following distal femoral fractures.
Methods
Patients over sixty-five admitted with a distal femoral fracture between June 2007 and 2012 were retrospectively identified. Patients mobility was categorised as unaided, walking aid, zimmer frame, or immobile. The 30-day, six-month, and one-year mortality rates were recorded for this group as well as for hip fractures during the same period.
Results
68 patients were included in the study. 85% of the patients were female and the mean age was 84 years. 8 patients (12%) had an underlying total knee arthroplasty. 43 patients (63%) were managed non-operatively and of those treated surgically 7 had plate fixation (28%) and 18 had intramedullary nailing (72%). The mortality rate for all patients with distal femoral fractures was 7% at 30 days, 26% at six months, and 38% at one year, higher than hip fractures during the same period by 8%, 13%, and 18%, respectively. Patients managed surgically had lower mortality rates and higher mobility levels.
Conclusion
Patients suffering a distal femoral fracture have a high mortality rate and surgical intervention seems to improve both mobility and mortality. Currently this group of patients obtains less attention and resources than hip fracture patients. Further research assessing the impact of increasing resources on this group of patient is required.
Level of evidence
IV
Conflict of Interests
The authors confirm that they have no relevant financial disclosures or conflicts of interest.
Ethical approval was not sought as this was a systematic review.
