الفهرس 
Anatomy of distal femurOnly 14 pages are availabe for public view
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Abstract
The goal of treatment of fractures of the distal femur is to provide anatomic reduction with stable internal fixation to allow for early active range of motion. This is more challenging when dealing with elderly patients having co morbidities both local (e.g. osteoporosis, osteoarthritis, and ipsilateral implants) and systemic illness, and deficits were predominant¬ly related to the increased age of the pa¬tients and concomitant limitations of the locomotor system. Percutaneous methods have been developed to minimize surgical exposure and lessen the risk of infection. Articular reduction and alignment should not be comprised for a small incision. Careful preoperative planning and meticulous operative technique will help reduce complication rates. Most fractures have high union rates. Radiographic malunion may not correlate to clinical symptoms. Rehabilitation protocols and physical therapy are equally critical in ensuring an acceptable outcome. Both femoral retrograde interlocking nail and locked compression plat of distal femur appear to have statistically insignificant differences regarding knee motion, pain, resuming function and rate of need of 2nd surgery. However retrograde nail is preferable to locked plat in terms of operative time, blood loss, and image intensifier exposure time, early appearance of callus, weight bearing, and shorter time required for full union. Also no incidence of delayed union, or nonunion. The main disadvantages of nail are; the frequent incidence of frontal plane angulations, shortening, and failure of distal locking screws which is the main cause of reoperation in nail group, and the possibility of repeated arthrotomy if the nail is removed. Distal femoral locking plates offer more fixation versatility without an apparent increase in mechanical complications or loss of reduction. Its insertion is more technically demanding than nail, Fracture treatment was performed by way of a minimally invasive approach, thus conserving as far as possible any intact soft tissue and fragment vascularity. Use of bicortical screws is essential in osteoporotic fractures. Locked plat is preferable to nail in terms of angulation and shortening. However still there is incidence of delayed union and nonunion. The incidence of reoperation was similar to nail group, however the procedures were not minor like the nail group. Based on our study; accepted outcome had been achieved with both methods compared with results of previous studies. However in our series nail showed more favorable outcome, less surgical morbidities, better rehabilitation. Clinicians should resist the ‘cookbook’ method of addressing these injuries and analyze patient factors, fracture geometry, and implant limitations when forming treatment plans. A surgeon should realize his comfort level with the injury and familiarization of implant choices. More similar studies are needed for results confirmation.