MODERN TREATMENT APPROACHES FOR FRACTURES OF THE DISTAL ONE-THIRD OF THE FEMUR

Fractures of the distal one-third of the femur represent a challenging group of injuries in orthopedic trauma due to their anatomical complexity, proximity to the knee joint, frequent comminution, and association with soft-tissue damage. These fractures occur in a bimodal population: young patients exposed to high-energy trauma and elderly patients with low-energy injuries often complicated by osteoporosis and multiple comorbidities. Over recent decades, treatment strategies have evolved significantly, shifting from extensive open surgical exposure toward biologically oriented fixation, minimally invasive techniques, and individualized decision-making. Modern treatment modalities include lateral locking plate fixation, minimally invasive plate osteosynthesis (MIPO), retrograde intramedullary nailing, and, in selected elderly patients, distal femoral replacement. This article reviews current concepts in the diagnosis, classification, surgical management, and rehabilitation of distal femoral fractures. Advantages and limitations of each technique are discussed, along with common complications and strategies for their prevention. The review emphasizes that optimal outcomes depend not on a single implant choice but on careful fracture assessment, preservation of soft tissues and blood supply, stable fixation, and early functional rehabilitation.