Assessment of Treatment Approaches for Compound Supracondylar Femur Fractures: A Prospective Comparative Study

Abstract

Introduction: Distal femur fractures, especially open fractures with polytrauma, pose significant challenges and can result in long-term disability. These fractures, comprising a small percentage of overall fractures, often occur due to high-velocity trauma in younger males or low-velocity injuries in the elderly. Management of such fractures, particularly in the elderly with osteoporosis, requires careful consideration. This study aims to evaluate the outcomes of different treatment strategies for open supracondylar and distal femoral fractures and to find the functional outcome. Materials and Methods: A prospective study was conducted on 20 patients aged 18 and above presenting with open supracondylar and distal femoral fractures between June 2021 and June 2023. Clinical and radiological evaluations were performed, and patients were grouped based on specific criteria. Treatment strategies included wound debridement, internal fixation using locking compression plates or dynamic condylar screws, external fixation, and minimal internal fixation. Patients were followed up at regular intervals for evaluation using the Knee Rate System Scoring. Results: The study included males with a mean age of 41 years. Road traffic accidents were the leading cause of fractures. Gustilo Anderson and Muller's classifications were used to categorize the injuries. Various treatment strategies were employed, with outcomes ranging from excellent to poor. Knee stiffness was the most common complication, with factors such as fracture severity and delayed surgery contributing to poor outcomes. Conclusion: While advancements in treatment have improved outcomes for distal femur fractures, particularly with early stable internal fixation, challenges remain, especially for severe injuries. External fixation, although useful as a temporary measure, often results in unsatisfactory outcomes. Soft tissue damage and adherence to early rehabilitation play crucial roles in determining functional outcomes. Overall, timely intervention and appropriate treatment selection are essential for optimizing outcomes in patients with open supracondylar and distal femoral fractures.