Series (1989 to 2005)

Background: The incidence of distal femur fractures is approxi-mately 37 per 100,000 person-years.1 Typically, distal femur fractures are caused by a high-energy injury mechanism in young men or a low-energy mechanism in elderly women.2Ma-naging these fractures can be a challenging task. Most surgeons agree that distal femur fractures need to be treated operatively to achieve optimal patient outcomes. The articular fracture component is usually treated with open reduction and internal lag screw fixation or external tension wire fixation (Illizarov). However, there is no consensus on the type of implant for the fixation of the metaphyseal–diaphyseal fracture component. Objective: The aim of this study is to systematically summarize and compare the results of different fixation techniques (traditional compression plating, antegrade nailing, retrograde nailing, submuscular locked internal fixation, and external fixation) in the operative management of acute nonperipros-thetic distal femur fractures (AO/OTA type 33A and C) and the characteristics of the fractures for each treatment (articular/ nonarticular and open/closed). Additionally an attempt was made to evaluate the impact of surgical experience on nonunion rate, fixation failure rate, deep infection rate, and secondary surgical procedure rate. In the context of this article compres-sion plating relates to techniques/implants that require compres-sion of the implant to the femoral shaft—it does not relate to interfragmentary compression. Key Words: distal femur fracture, supracondylar femur fracture, intercondylar femur fracture, systematic review, meta-analysis