Practical approach to the native distal femur fractures in the elderly: A rapid review over the recent trends

  • Mohamad Tahami
    Orthopaedic surgeon, Fellowship of Knee, Sport and reconstruction surgery, Department of Orthopaedic surgery, Chamran Hospital, Shiraz University of Medical Sciences, Bone and Joint disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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  • Arash Sharafat Vaziri
    Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
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  • Mohammad Naghi Tahmasebi
    Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
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  • Fardis Vosoughi
    Corresponding author at: Orthopaedic surgeon, Fellowship of Knee, Sport and reconstruction surgery, Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran.
    Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
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  • Majid Khalilizad
    Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
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  • Saeed Shakiba
    Department of Orthopaedic and Trauma Surgery, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
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  • Rodrigo Fernando Pesántez
    Department of Orthopaedic and Trauma Surgery, Fundacion Santa Fe de Bogotá, Universidad de los Andes
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      • Challenges unique to osteoporotic distal femur fractures need to be recognized, anticipated and thoroughly addressed.
      • never miss a Hoffa fracture by obtaining computed tomographic imaging.
      • Regarding retrograde nailing, modern designs, help prevent the ‘Bell-Clapper’ effect.
      • Despite biomechanical advantages of a lateral LISS plate, the need for augmented plating or additional fixation should not be overlooked in complex cases.
      • Always beware of neglecting the severity of the underlying osteoarthritis. Replacement might be the preferred choice in selected cases.


      Significant work has been done in recent years on treatment strategies for distal femur fractures. Inclusive reviews on periprosthetic fractures of distal femur have been carried out recently, but there is a lack of such reviews on the subject of native distal femur fractures in the recent literature. In this narrative review, we are set out to address the latest updates on geriatric non-periprosthetic distal femur fractures, and perform a rapid review over different treatment options, arriving at a summarized proposed treatment algorithm.



      ODFF (osteoporotic distal femur fracture), RIMN (retrograde intramedulary nail), CT scan (computed tumography scan), MIPO (minimally invasive plate osteosynthesis)
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