Civilian Ballistic Distal Femur Intraarticular Fracture Patterns

The purpose of this study was to assess the rate and pattern of intraarticular extension of ballistic distal femur fractures. The authors examined all ballistic distal femur fractures that presented to their hospital between 2015 and 2019. The authors excluded direct condylar injuries and patients of whom a computed tomography (CT) scan was not obtained. The authors classified the rate of intraarticular extension and the pattern of that extension. Sixty-three fractures met inclusion in this study. Of these, 19 (30%) extended intraarticular, whereas the remaining 44 did not. Ninety-five percent of the fractures in the intraarticular group contained a sagittal fracture, whereas only 26% contained a fracture in the coronal plane. Ballistic distal femur fractures have a lower rate of intraarticular extension than blunt fractures. There are predictable patterns of joint involvement with ballistic injuries that warrant different treatment strategies. The authors propose a new classification system to further classify these unique fractures. (Journal of Surgical Orthopaedic Advances 33(3):178-180, 2024).