Distal Femoral Fractures in the Elderly: Assessment of Length of Stay and Morbimortality

Abstract

Introduction Distal femoral fractures (DFF) are a relevant problem for public health worldwide. As the population ages, an increase in the rate of these lesions is expected in the next few years.

Objective To describe the complications and mortality from DFF in geriatric patients.

Materials and Methods A descriptive and retrospective study with patients aged 60 years or older who underwent surgery due to DFF. All subjects received treatment in the same trauma center from 2011 to 2015 and underwent a minimum follow-up of 1 year. Patients with incomplete medical records were excluded. We analyzed demographics, radiological findings, local and systemic complications, length of stay, and mortality rates.

Results In total, 16 patients met the inclusion criteria; their median age was of 72 (range: 61 to 93) years, and 14 subjects (87,5%) were female. The classification of the Association for the Study of Internal Fixation (Arbeitsgemeinschaft für Osteosynthesefragen, AO, in German) was as follows: A – 12 patients (75%); B – 2 patients (12.5%); and C – 2 patients (12.5%). There were no open fractures. The devices used in the operations included dynamic condylar screw (DCS) plates (9 subjects; 56%), distal femur locking compression plates (LCPs) (4 subjects; 25%), and retrograde distal femoral nails (DFNs) (3 subjects; 19%). The median time until surgery was of 10 (range: 3 to 27) days, with a median length of stay of 14 (range: 5 to 47) days. Complications were presented by 6 (37.5%) patients: 2 (12.5%) cases of pulmonary thromboembolism and 4 (25%) cases which required reintervention (2 due to hardware failure, 1 because of arthrofibrosis, and 1 due to aseptic nonunion); there were no cases of infection. The mortality rate at 12 months was of 0%.

Conclusion The patients with DFF in this geriatric cohort presented a long length of stay, with a high rate of complications, including a rate of 25% of reintervention. Nevertheless, the 1-year mortality rate was of 0%.

Keywords

distal femoral fractures - geriatric population - lenght of stay - mortality

Publication History

Received: 14 April 2020

Accepted: 18 August 2020

Article published online:
03 May 2024

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