Management of Distal Femoral Fractures in the Elderly

Distal femoral fractures (DFF) cause significant morbidity and mortality comparable with neck of femur fractures. In view of this, NICE, National Institute of Clinical Excellence, has introduced a Best Practice Tariff (BPT) for management of distal femoral fractures in the elderly to improve morbidity and reduce regional variation of standards. Operative management includes application of external fixation, open reduction and internal fixation, or arthroplasty. While these are associated with significant morbidity, non-operative management may also be considered with immobilisation or traction. A comprehensive multidisciplinary team approach is required for pre-operative assessment, management planning, as well as post-operative rehabilitation. We provide a concise summary on distal femoral fractures covering clinical presentation, management and associated complications, in order to highlight the importance of these injuries and to help develop an understanding as to why they have been prioritised at a national level.