Treatment of isolated complex distal femoral fractures by external fixation

Thirteen patients with isolated distal femoral fractures were treated by ex ternal fixation. There were seven males and six females with an average age of 45 years. Four were Type A3 fractures, one Type C1, five Type C2 and th ree Type C3 fractures. Seven of these were open. In seven cases the articul ar surface was first reduced and fixed. The fixation was extended across th e knee to supplement the distal fixation in six severe cases. The average f ollow up was 30 months. There was one non-union in the study with the average time to union in the other patients being six months. Using the Mite criteria for assessing clin ical results we found that nine patients obtained a good to excellent score and four were classed as failures. The average range of movement of the kn ee in the study was 100 degrees. Apart from the single non-union all the fr actures healed and there were no other serious complications. Considering the severity of the fractures we did not find any evidence to s uggest that temporary fixation of the lateral soft tissues by fixator pins was detrimental. The results suggest that external fixation may be used to treat these difficult fractures without the risk of serious complications. (C) 2000 Elsevier Science Ltd. All rights reserved.