G Pietu1, M Lebaron2, X Flecher2, C Hulet3, E Vandenbussche4. 1. Service de chirurgie orthopédique et traumatologique, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France. Electronic address: guy.pietu@chu-nantes.fr. 2. Service de chirurgie orthopédique, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille cedex 09, France. 3. Département de chirurgie orthopédique et traumatologique, Niveau 11, Inserm U 1075 COMETE, université de Caen Basse-Normandie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France. 4. Service de chirurgie orthopédique et traumatologique, université René-Descartes, hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Abstract
INTRODUCTION: Epidemiological study of femoral fractures has been dominated by proximal fractures. Distal fracture requires equal attention for correct management. PATIENTS AND METHODS: A prospective study in 12 French hospital centres between June 1st, 2011 and May 31st, 2012 recruited cases of non-pathologic distal femoral fracture in patients over 15 years of age without ipsilateral knee prosthesis. RESULTS: There were 183 fractures in 177 patients. Mean age was 63.5 years. Female patients (60.5%) were significantly older than males (mean age, respectively 73 versus 48.4 years). Walking was unrestricted in only 83 patients (46.89%). On the AO/OTA (Orthopaedic Trauma Association) classification, there were 86 type A fractures (47%), 29 type B (15.8%) and 68 type C (37.2%). Fractures were open in 32 cases (17.5%), most frequently in male, young patients and type C fracture. Causal trauma was low-energy (fall from own height) in 108 cases, most frequently in female patients and type A fracture. Forty-five patients were proximal femoral implant bearers. CONCLUSION: Distal femoral fracture shows highly variable epidemiology. AO/OTA type A fracture mainly involves elderly, relatively dependent female subjects. Outcome study requires radiographic data and assessment of functional capacity. LEVEL OF EVIDENCE IV: Prospective cohort study.
INTRODUCTION: Epidemiological study of femoral fractures has been dominated by proximal fractures. Distal fracture requires equal attention for correct management. PATIENTS AND METHODS: A prospective study in 12 French hospital centres between June 1st, 2011 and May 31st, 2012 recruited cases of non-pathologic distal femoral fracture in patients over 15 years of age without ipsilateral knee prosthesis. RESULTS: There were 183 fractures in 177 patients. Mean age was 63.5 years. Female patients (60.5%) were significantly older than males (mean age, respectively 73 versus 48.4 years). Walking was unrestricted in only 83 patients (46.89%). On the AO/OTA (Orthopaedic Trauma Association) classification, there were 86 type A fractures (47%), 29 type B (15.8%) and 68 type C (37.2%). Fractures were open in 32 cases (17.5%), most frequently in male, young patients and type C fracture. Causal trauma was low-energy (fall from own height) in 108 cases, most frequently in female patients and type A fracture. Forty-five patients were proximal femoral implant bearers. CONCLUSION: Distal femoral fracture shows highly variable epidemiology. AO/OTA type A fracture mainly involves elderly, relatively dependent female subjects. Outcome study requires radiographic data and assessment of functional capacity. LEVEL OF EVIDENCE IV: Prospective cohort study.