Minimally invasive method for treatment of supra-diacondylar femoral fractures

The "gold standard" treatment modality for extra-articular and combined intra-, extra-articular fracture of the distal femur is the condylar blade plate (CP). Large exposure of the distal femur with unavoidable iatrogenic trauma to the soft tissue surrounding the fracture site and perhaps the lack of stiffness of the eccentric lateral cortical location of the CP has been suggested to play a role in the high rate of infections and pseudarthrosis reported in the literature. In an effort to overcome some of the difficulties with the condylar blade plate and to reduce complications, an unreamed, titanium, solid nail, locked proximally with two locking screws and distally with a screw and twisted blade was developed (DFN). The nail was designed for minimal invasive reduction through a small median parapatellar arthrotomy of the articular fracture (percutaneous screw) and of the supracondylar fracture. The DFN is a modular system sharing many components and almost all instrumentation with the AO-UFN and it is expected that the nail is much better in axial stiffness and strength than the condylar blade plate. The treatment of supracondylar femoral fractures should be improved by providing early weight bearing and accelerated fracture healing with a reduced incidence of delayed unions and infections.