Surgical Treatment of Distal Femur Fractures in Patients with Concomitant and Multiple Injury

On the base of experience in treatment of 114 patients with concomitant and multiple injury (1996-2003) the indications, terms and tactics of operative intervention in complicated comminuted fractures of distal femur were determined. During resuscitation period in open fractures primary debridment and stabilization with external fixation devices was performed. In closed fractures immobilization by skeletal traction; in movement irritation - by external fixation device was used. At 10-21 day after trauma deep osteosynthesis with fixatives (angular plate - 51 fractures, condylar plate - 30 fractures, DCS - 6 fractures, DCP - 18 fractures) was carried out. In presence of other fractures of ipsilateral and contralateral limb the modem fixatives (DFN - 4 cases, UFN - 3 cases) were used. Application of low invasive technique allowed to perform the osteosynthesis of all fractures simultaneously. Long term results were evaluated in 53 patients (59 distal femurfractures) atfollow up 1-6 years. Excellent results were achieved in 30 (50,8%), good - in 14 (23,7%), satisfactory - in 7(11,9%) and unsatisfactory - in 8 (13,6%) cases.