Open Reduction and Internal Fixation of Distal Femoral Fractures in Adults Periprocedural Care

Updated: Sep 18, 2017
  • Author: Jeffrey D Thomson, MD; Chief Editor: Dinesh Patel, MD, FACS  more...
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Periprocedural Care

Equipment

Necessary equipment depends on technique and includes the following:

  • 95º blade plate
  • 95º condylar screw
  • Distal femur buttress plate
  • External fixator
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Patient Preparation

Anesthesia

General anesthesia is used for complete muscle relaxation to facilitate anatomic fracture reduction.

Positioning

The patient is positioned supine on a flat-top Jackson table to allow C-arm imaging. An ipsilateral bump is placed underneath the hip to allow some internal rotation to gain lateral exposure to the distal femur.

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Monitoring & Follow-up

Postoperative immobilization depends on the rigidity of your construct and fracture stability. If the fracture is rigidly fixed, a hinged knee brace may be used postoperatively to allow knee range of motion (ROM) and no weightbearing on the extremity until bone healing is evident at approximately 12 weeks. [5]

If the fixation construct is not rigid, the patient may be immobilized in a splint for approximately 4-6 weeks and then transitioned to a hinged knee brace.

Radiographs at regular intervals are necessary to assess fracture healing. Patients may be seen initially at 2 weeks postoperatively and then at monthly intervals until the fracture is healed.

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