Abstract: Introduction: Open distal femoral fractures are not rare and are difficult to manage. In open grade III injuries, according to Gustilo-Anderson’s classification of Open fractures, due to massive trauma to the soft tissue and loss of bone, chaotic mindset of treating doctor compels him to fall prey to petty methods of fixation leading to inferior results.
Method: We studied a group of 24 patients with open distal femur fractures with or without bone loss, classified them and treated according to the steps described in our treatment flow chart. We have tried to formulate a standard, reproducible method of treating such fractures according to priority and need.
Results: We achieved 79.2% good to excellent results according to Knee Society Scoring system on treatment of open distal femoral fractures with author’s preferred treatment. This is comparable with many other similar studies pointing towards the fact that our treatment protocol and scoring system for these fractures are worthwhile.
Conclusion: We conclude that immediate management in emergency department, early shifting of patient to the operating room and stabilizing the fracture and carrying out proper debridement of wound and depot antibiotics are important steps in management. Vacuum assisted dressings, sequential debridement, autologous bone grafts, double plate fixation and staged wound management can give good results in the hands of any surgeon.
