Abstract: The distal femur fractures are complex injuries, and it can be challenging to manage. These fractures often are unstable, comminuted and tend to occur in elderly or multiply injured patients. Because of the proximity of these fractures to the knee joint, regaining full knee motion and function may be difficult. 1 If the fracture of the hip square measure excluded, 31% of femoral fractures involve the distal portion. Distal femur fractures by definition require distal 9 cm of the femur
[2].
Extra-articular fractures of the distal femur are serious injuries that frequently result in varying degrees of permanent disability. The degree of functional loss is often the result of articular cartilage and bone damage, softtissue injury or a combination thereof [3].
Several published studies in the 1960s reported better results with non- surgical than surgical management of distal femur fractures [10, 11]. But now, the most predictable results are presently attained with surgical interventions, and it is now recognized that operative fixation with ability to obtain an anatomical reduction of the joint surface, restoring axial alignment and beginning early range of motion present clear advantage over closed means of treatment [12-16] In 1970, the AO (Arbeitsgemeinschaft fur Osteosynthesefragen) reported "if normal or near-normal function is to be achieved then unquestionably, if correctly employed, open reduction and internal fixation ensures a very high rate of success" [1]. The AO has used angled blade plate in the treatment of these fractures, but there was an increased incidence of infection, inadequate fixation in the osteoporotic bone, malunion and the need for bone grafting in many cases [8].
In cases with severe metaphyseal comminution, supracondylar nailing offers a lot of biological technique of fixation with less reduction of sentimental tissue. Fixation of intercondylar fractures is also possible with additional compression screws to stabilise the intra-articular fragments. Metaphyseal fragments are left undisturbed, which limits the need for bone grafting. It is especially useful in obese patients and fractures occurring below hip implants or above total knee implants that have an open notch design. It provides excellent axial and rotational stability for treating both open and closed fractures resulting in early mobilisation. Furthermore, small incision area results in rapid recovery with minimal morbidity for the patient.
