A fracture near the lower end of the thighbone can cause severe pain, prevent weight-bearing, and disrupt the surface and movement of the knee joint. Because distal femur fractures may involve multiple bone fragments or extend into the joint, prompt evaluation is important to protect mobility and support proper healing.
Dr. Brian Cohen has completed more than 100,000 patient evaluations and provides individualized treatment for distal femur fractures in Columbus, OH. Care depends on the fracture pattern, bone quality, overall health, and condition of the surrounding knee joint.
What Is a Distal Femur Fracture?
A distal femur fracture is a break in the lower portion of the femur, or thighbone, directly above the knee. The distal femur widens near its lower end and forms the upper portion of the knee joint.
Distal femur fractures are relatively uncommon. In younger adults, they are usually caused by a high-energy injury, such as a motor vehicle collision or significant fall. In older adults with osteoporosis or reduced bone strength, a fracture may result from a lower-impact fall or twisting injury.
Types of Distal Femur Fractures
Distal femur fractures vary in pattern and severity. A single injury may fit more than one of the following classifications:
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Transverse fracture: The bone breaks in a relatively straight line across the femur.
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Comminuted fracture: The bone breaks into three or more fragments.
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Intra-articular fracture: The fracture extends into the knee joint and disrupts the normally smooth joint surface.
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Closed fracture: The surrounding skin remains intact.
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Open fracture: A wound extends from the skin to the fracture, with or without bone visible through the skin.
An open fracture is a medical emergency because bacteria can enter the wound and cause a serious infection.
Distal Femur Fracture Diagnosis
Diagnosis begins with a discussion of how the injury occurred and whether the patient can move the leg or bear weight. Dr. Cohen or one of his orthopedic colleagues will examine the leg for swelling, tenderness, wounds, deformity, circulation, sensation, and other possible injuries.
X-rays are used to confirm the fracture and show the position of the bone fragments. A CT scan may be ordered when the fracture extends into the knee joint or when more detail is needed for surgical planning. Patients injured in a high-energy accident may also require evaluation for injuries to other parts of the body.
Distal Femur Fracture Causes and Risk Factors
Distal femur fractures commonly affect two groups: younger people who sustain high-energy trauma and older adults with reduced bone strength.
In younger patients, common causes include:
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Motor vehicle or motorcycle collisions
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Falls from a significant height
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High-impact sports injuries
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Other forms of severe trauma
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Abnormal knee alignment
In older adults, these fractures may occur after:
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A fall from standing height
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A twisting injury
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A relatively minor impact when osteoporosis is present
Reduced bone density and an existing knee replacement may increase the complexity of the injury. A fracture that develops around or immediately above a knee replacement is known as a periprosthetic distal femur fracture.
Distal Femur Fracture Symptoms
Symptoms of a distal femur fracture may include:
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Severe pain near the lower thigh or knee
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Swelling and bruising
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Tenderness around the fracture
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Difficulty moving or straightening the leg
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Inability to stand, walk, or bear weight
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Visible deformity
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Shortening or abnormal rotation of the injured leg
An open wound near the fracture, visible bone, loss of sensation, a pale or cold foot, or uncontrolled bleeding requires emergency medical care.
Distal Femur Fracture Treatment Options
Treatment depends on whether the fracture is displaced, stable, open or closed, and involved in the knee joint. Dr. Cohen also considers bone quality, existing knee arthritis or implants, other injuries, and the patient’s overall health.
Some stable fractures may be treated with a brace or cast and closely monitored with follow-up X-rays. Temporary traction may occasionally be used to maintain alignment before surgery or while other medical concerns are addressed.
Surgery is commonly recommended when the fracture is displaced, unstable, open, divided into multiple pieces, or extends into the knee joint.
External Fixation
External fixation uses metal pins placed through the skin and into the bone above and below the fracture. The pins connect to a stabilizing frame outside the body that holds the bone in a safer position.
This approach may be used temporarily when there is severe swelling, an open wound, significant soft-tissue damage, other serious injuries, or a medical condition that makes immediate internal fixation unsafe. Once the patient and surrounding tissues are ready, the external fixator may be replaced with plates, screws, or an intramedullary nail.
Internal Fixation
Internal fixation involves repositioning the bone fragments and securing them while the fracture heals. The implants selected depend on the fracture pattern, bone quality, and whether the break extends into the knee joint.
Treatment may include:
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Plates and screws: A plate is positioned along the outer surface of the femur and secured with screws.
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Intramedullary nailing: A metal rod is inserted into the hollow center of the femur and secured with locking screws.
When the fracture extends into the knee joint, Dr. Cohen carefully restores the joint surface before stabilizing the remaining fragments. Proper alignment is important for knee movement and may help reduce the risk of post-traumatic arthritis.
Knee Replacement or Distal Femoral Replacement
In selected cases, replacing the damaged portion of the knee may be considered instead of repairing the fracture with plates, screws, or a nail. This option may be appropriate for an older patient with severely weakened bone, extensive fragmentation that cannot be reconstructed reliably, advanced knee arthritis, or certain fractures around an existing knee replacement.
The procedure may involve a specialized knee implant or distal femoral replacement. Because this is a major operation, Dr. Cohen considers the patient’s health, mobility, bone quality, joint condition, and rehabilitation needs before recommending it.
Why Choose Dr. Cohen?
OVER 25+ YEARS OF EXPERIENCE
One of the first orthopedic surgeons employed by a large hospital. Dr. Cohen spent 20 years.
TRUSTED BY OVER 100,000+ PATIENTS WORLDWIDE
Over his distinguished career, Dr. Cohen has cultivated a reputation of excellence and trust among his patients and his peers.
UTILIZING THE LATEST TECHNOLOGY
To achieve the best surgical outcomes, Dr. Cohen uses the most advanced technologies and techniques, keeping his practice state-of-the-art.
PATIENT SAFETY IS TOP PRIORITY
An individualized, patient-focused process coupled with decades of training and experience helps ensure maximum safety for all of Dr. Cohen’s patients.
Distal Femur Fracture Care in Columbus, OH
A distal femur fracture can affect knee alignment, joint movement, and the ability to walk or bear weight. Dr. Cohen evaluates the fracture pattern, bone quality, joint involvement, and overall health before recommending bracing, fixation, or joint replacement in selected cases. Prompt, individualized treatment can support bone healing and help restore mobility. To schedule a consultation with Dr. Brian Cohen, call (614) 788-0375.
