A distal femur fracture is a break in the lower end of the thigh bone, at or near the knee joint. It is a less common but functionally significant fracture, affecting both younger patients in high-energy trauma and older patients in low-energy falls. Treatment depends on fracture pattern, displacement, intra-articular involvement, and bone quality.
What Is a Distal Femur Fracture?
The distal femur is the lower end of the thigh bone, which forms the upper half of the knee joint at the femoral condyles. Fractures occur in three general patterns:
- Supracondylar: above the femoral condyles, typically extra-articular
- Intercondylar: extending into the joint surface between the medial and lateral condyles, intra-articular
- Condylar: involving one of the femoral condyles, intra-articular
Intra-articular fractures are more complex and have a higher risk of post-traumatic arthritis. Periprosthetic distal femur fractures (around a prior knee replacement) require additional planning because of the implant.
Causes and Risk Factors
- High-energy trauma (motor vehicle collisions, falls from height, sports collisions) in younger patients
- Low-energy falls in older patients with osteoporotic bone
- Periprosthetic fracture around a prior knee replacement
- Pathologic fracture from bone tumor or metabolic bone disease
- Repetitive stress in athletes (stress fractures)
- Osteoporosis
Symptoms
- Severe pain at the lower thigh and knee following injury
- Inability to bear weight
- Visible deformity in displaced fractures
- Significant swelling and bruising
- Restricted knee motion
- Possible neurovascular symptoms (numbness, weakness, decreased pulse) requiring urgent evaluation
Diagnosis
Dr. Chudik’s evaluation prioritizes neurovascular assessment and rules out compartment syndrome. X-rays in multiple views define the fracture pattern. CT is added for intra-articular fractures because the axial and coronal reconstructions characterize joint surface involvement and displacement that drive surgical planning. The Westmont office has on-site high-field MRI and X-ray.
Treatment
Non-surgical treatment with a hinged knee brace or cast is reserved for non-displaced, stable extra-articular fractures, particularly in lower-demand patients.
Surgical treatment is indicated for:
- Displaced fractures
- Intra-articular fractures with joint surface displacement
- Open fractures (an emergency)
- Periprosthetic fractures with implant compromise
- Polytrauma
Dr. Chudik performs open reduction and internal fixation with anatomically contoured locking plates that provide strong fixation in osteoporotic bone. Retrograde intramedullary nails are an alternative for selected supracondylar fractures. Periprosthetic fractures may require revision arthroplasty in addition to fracture fixation when the implant is loose.
Recovery and Outcomes
Recovery after surgical fixation typically includes protected weight-bearing for 8 to 12 weeks, progressive range of motion starting within days, and progressive strengthening over three to six months. Bone union typically occurs by three to four months. Return to sport, when possible, is usually six to 12 months.
Outcomes depend on fracture pattern, joint surface restoration, and bone quality. Stiffness and post-traumatic arthritis are the most common late complications.
When to See Dr. Chudik
Schedule urgent evaluation after any significant injury to the lower thigh or knee with severe pain, inability to bear weight, visible deformity, or any neurovascular symptoms. Call 630-324-0402 or request an appointment online.