Peace of Mind About ORIF and Segmental Replacement for Tough Distal Femoral Fractures

A large-database study used some statistical heroics to deliver an answer — the 10-year behavior both of ORIF and distal femoral replacement

What’s the Claim?

A large, statewide database from California was used to support a propensity-matched study comparing ORIF to distal femoral replacement for distal femoral fractures in patients over the age of 65. Among those treated with ORIF, the 10-year risk of conversion to arthroplasty was 3.5%, with women and younger patients being at higher risk. After matching for factors known to be associated with reoperation (diabetes, other comorbid conditions, BMI, and insurance type, among others), the two approaches did not differ in terms of 10-year survival free from revision, with both groups’ survivorship being in the mid-90% range. The 90-day risk of “wound or joint infection” was higher in patients undergoing distal femoral replacement arthroplasty (2% versus 0.2%).

How’s It Stack Up?