Optimal Management of the Patient With an Open Distal Femur Fracture

Open fractures of the distal femur present several challenges to the treating surgeon as well as the patient. Patients who sustain this injury are at risk for a variety of complications including nonunion, malunion, post-traumatic arthritis, limited function, need for multiple surgical procedures and in some cases, amputation. This article will review initial care of the injured patient, important facets of open fracture care, management of injured soft tissues, strategies for internal fixation in order to optimize outcomes and minimize complications. Additionally, management of nonunion and malunion of the distal femur, including the role for creation of anticipated nonunion following aggressive debridement of nonviable bone, are addressed.