The aim of this study was to assess the feasibility of conducting a full-scale, appropriately powered, randomized controlled trial (RCT) comparing internal fracture fixation and distal femoral replacement (DFR) for distal femoral fractures in older patients. Seven centres recruited patients into the study. Patients were eligible if they were greater than 65 years of age with a distal femoral fracture, and if the surgeon felt that they were suitable for either form of treatment. Outcome measures included the patients’ willingness to participate, clinicians’ willingness to recruit, rates of loss to follow-up, the ability to capture data, estimates of standard deviation to inform the sample size calculation, and the main determinants of cost. The primary clinical outcome measure was the EuroQol five-dimensional index (EQ-5D) at six months following injury.Aims
Patients and Methods
We reviewed seven patients with coronal fractures of the lateral femoral condyle and studied the mechanism of injury and the radiological features. The influence of soft tissue attachments on the displacement and the blood supply were investigated by clinical and cadaveric studies. All three fractures which were initially undisplaced lost position early during conservative management. Internal fixation gave good results at review, and is recommended to avoid the risk of malunion and possible secondary osteoarthritis.
