Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec 5;90(12-S):25-32.
doi: 10.23750/abm.v90i12-S.8958.

Osteoporotic distal femur fractures in the elderly: peculiarities and treatment strategies

Gianluca Canton  1 , Gioia Giraldi, Micol Dussi, Chiara Ratti, Luigi Murena
Affiliations
Review

Osteoporotic distal femur fractures in the elderly: peculiarities and treatment strategies

Gianluca Canton et al. Acta Biomed. .

Abstract

Distal femur fractures account for 4-6% of osteoporosis related fractures of the femur in the elderly population. They represent a relevant cause of morbidity and mortality in the geriatric population with a reported 1-year mortality reaching 30%. Non-displaced fractures or even displaced fractures in patients with high operative risk can be treated conservatively. However, operative treatment is the most widely accepted management option for displaced fractures. The advantage resides in early mobilization and weight-bearing, reducing risks related with a prolonged immobilization when compared with conservative treatment. On the other hand, the intrinsic difficulty of fixing an osteoporotic bone is a major concern. The presence of osteosynthesis devices or prosthetic implants in the femur can make the surgical treatment more challenging, sometimes limiting therapeutic options. Aim of the present paper is to review the most recent literature about osteoporotic distal femur fractures in the elderly, including periprosthetic and other hardware related fractures, to highlight current evidence on management options and related results as a guide for the daily clinical practice.

PubMed Disclaimer

Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

Figures

Figure 1.
Figure 1.
AP (a) and lateral (b) radiographs of a distal femur fragility fracture in a 90 years old woman with severe osteoporosis
Figure 2.
Figure 2.
Stress riser related fracture a) 82 years-old woman treated with a too short locking plate for periprosthetic knee fracture and a previously implanted trochanteric nail, b) stress raiser related fracture between the implants as a consequence of low energy trauma
Figure 3.
Figure 3.
a) 79 years-old woman reporting a distal femur fragility fracture between a total knee arthroplasty and a previously implanted antegrade intramedullary nail b) radiographic control 2 years after open reduction and internal fixation with a locking plate stabilized with screws and cerclages (reprinted with permission from “Canton G. et al., Acta Biomed. 2017 Jun 7;88(2S):118-128. doi: 10.23750/abm.v88i2 -S.6522”).
See this image and copyright information in PMC

References

    1. Myers P, Laboe P, Johnson KJ, Fredericks PD, Crichlow RJ, Maar DC, et al. Patient Mortality in Geriatric Distal Femur Fractures. J Orthop Trauma. 2018 Mar;32(3):111–115. - PubMed
    1. Athar SM, Fazal MA, Hassan M, Ashwood N. Distal Femoral Fractures in the Elderly: Does Early Treatment with Locking Plates Reduce Mortality Rates. Clin Res Open Access. 2017;3(1)
    1. Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality After Distal Femur Fractures in Elderly Patients. Clin Orthop Relat Res. 2011 Apr;469(4):1188–1196. - PMC - PubMed
    1. Jordan RW, Chahal GS, Davies M, Srinivas K. A Comparison of Mortality following Distal Femoral Fractures and Hip Fractures in an Elderly Population. Adv Orthop Surg. vol. 2014 Article ID 873785, 4 pages, 2014. https://doi.org/10.1155/2014/873785 .
    1. Ehlinger M, Ducrot G, Adam P, Bonnomet F. Distal femur fractures. Surgical techniques and a review of the literature. Orthop Traumatol Surg Res. 2013 May;99(3:3):53–60. - PubMed