Use of 95-Degree Angled Blade Plate With Distal Femoral Fractures in Patients Over 65-Years Old of Age

The aim of this study was to evaluate patients over 65 years old treated with an angled blade plate (ABP) for distal femoral fractures and determine if the use of ABP was reasonable in this specific population who are prone to complications.

Consecutive patients with distal femoral fracture who had undergone open reduction and internal fixation with ABP plate between January 2010 and December 2023 were retrospectively analyzed. Medical records were reviewed for age, sex, follow-up, injury characteristics, fracture pattern, and complications, such as malunion, non-union and infection. Clinical evaluation of patients was performed using the international Knee Documentation Committee (IKDC) score.

Twenty-one (18 female; 85.7%) patients were included, with a median (range) age of 78.5 (65-92) years. Mean follow-up was 17 months. Four of the patients sustained high-energy trauma fractures and the remainder fractured because of a simple fall; five were admitted due to the nonunion and three because of complications related to intramedullary nail. Most (85%) had periprosthetic fracture. Only 2/21 (9.5%) had nonunion and implant failure and were revised again with ABP and iliac crest autograft. Furthermore, only 1 (4.8%) with superficial infection needed surgical debridement in the early postoperative period. After a minimum of 12 months follow up the mean IKDC score was 37 (range 21-72).

ABP appears to be a reliable device for the treatment of distal femoral fractures in patients over 65 years, including those with osteoporotic and periprosthetic fractures, and non-unions, with a 90% union rate.