Distal femur fracture fixation is an operation to repair a fracture of the lower end of the thighbone near the knee joint using plates and screws or an intramedullary nail. These fractures often involve the knee joint surface.
An incision is made on the outer side of the knee and lower thigh. The joint surface is reconstructed anatomically and fixed with screws. A locking plate or retrograde intramedullary nail is then applied to stabilise the shaft component. The operation takes one and a half to three hours depending on complexity.
Surgery is required for almost all displaced distal femur fractures to restore the joint surface and allow rehabilitation. These fractures are common in elderly patients with osteoporosis and in high-energy injuries in younger patients.
Rarely appropriate for displaced fractures. Undisplaced fractures may be managed in a hinged knee brace with restricted weight-bearing.
CT scan for joint surface planning. Surgery within days of injury.
Restoration of the knee joint surface and femoral alignment. Most patients achieve a functional knee, though recovery is prolonged.
Very common. Aggressive physiotherapy is essential.
Significant thigh and knee swelling for several months.
Significant blood loss. Transfusion may be needed.
Distal femur fractures can be slow to heal. May require bone grafting.
Healing in an imperfect position.
If the joint surface was involved.
Deep infection around metalwork.
In patients with existing knee replacements.
DVT despite preventive measures.
General or spinal anaesthesia.
Weight-bearing depends on fracture pattern and fixation — often restricted for six to twelve weeks. Knee range of motion exercises begin within the first few days. Physiotherapy is critical. Full recovery six to twelve months.
Regular X-rays at six weeks, three months, and six months.
This depends on the fracture pattern and quality of fixation. Your surgeon will guide weight-bearing progression.
If significant post-traumatic arthritis develops years later, knee replacement may eventually be needed.