Comminuted Fractures of the Distal Femur Treated with Ilizarov External Fixator. Case Series Study

Distal femoral fractures constitute a type of lower limb injuries that is rare and difficult to treat. Despite advances in surgical technique and development of implants used for internal fixation of fracture fragments, the treatment continues to result in numerous complications. The Ilizarov External Fixator reduces the risk of complications and allows for bone union.

Six men with distal femoral fractures resulting from multisite and multiorgan injuries were treated at the Department of Orthopaedics and Musculoskeletal Traumatology of the Medical Uni-versity of Warsaw between 2008 and 2016. Mean age of the patients was 42.6 years. Four of them were mana-ged with the Ilizarov method as a primary treatment and two wore the apparatus as a second-line treatment following unsuccessful plate osteosynthesis.

Mean treatment duration with the Ilizarov apparatus was 29 weeks. Bone union was achieved in all patients. After the treatment, the patients ambulated unassisted, without orthopaedic aids. All patients re-turned to work.

1. The Ilizarov method allows for efficient fixation of comminuted distal femoral fractures, in-clud-ing C2 and C3 intra-articular fractures (AO/ASIF classification). 2. The use of the Ilizarov apparatus re-duces soft tissue laceration, preserves blood supply to the bone fragments, and allows for easier skin care, which is particularly important in the case of open fractures. 3. Early rehabilitation with the patient fully loading the operated limb reduces muscle atrophy and stimulates bone union.