Introduction. Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. Currently this cohort is not afforded the same resources as those with hip fractures. This study aims to compare their mortality rates and assess whether surgical intervention improves either outcome or mortality following distal femoral fractures. Methods. Patients over sixty-five admitted with a distal femoral fracture between June 2007 and 2012 were retrospectively identified. Patients mobility was categorised as unaided, walking aid, zimmer frame, or immobile. The 30-day, six-month, and one-year mortality rates were recorded for this group as well as for hip fractures during the same period. Results. 68 patients were included in the study. The mortality rate for all patients with distal femoral fractures was 7% at 30 days, 26% at six months, and 38% at one year, higher than hip fractures during the same period by 8%, 13%, and 18%, respectively. Patients managed surgically had lower mortality rates and higher mobility levels. Conclusion. Patients suffering a distal femoral fracture have a high mortality rate and surgical intervention seems to improve both mobility and mortality. 1. Introduction Distal femoral fractures can result from either high energy injuries in young adults or low energy injuries in elderly patients with osteoporotic bone [1–3]. This injury accounts for around 6% of all fragility fractures [3] and its frequency is likely to rise with the increasing geriatric population. The prevalence of periprosthetic fractures following knee arthroplasty is 0.5%–2.2% [4, 5] which is also likely to increase with the rise in arthroplasties being performed [6]. Patients suffering a distal femoral fracture are at a high risk of complication given the prevalence of medical comorbidities in this cohort [7–9]. The mortality rates have been reported to be around 18% at six months and 18–30% at one year [1, 2, 10, 11]. The presence of either a knee arthroplasty or a significant comorbidity is associated with an increased mortality [2]. The injury has a significant effect on patients’ mobility with one series reporting only 18% were able to walk unaided with 23% housebound and 26% not able to perform social activities [12]. Traditionally traction followed by cast bracing was the common treatment technique [13]; however this option results in prolonged bed rest [14], loss of motion [15, 16], and either nonunion or malunion [17]. Butt et al. performed a randomised controlled trial comparing six weeks of traction followed by bracing with plate fixation.
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