Description
In this presentation, Enis Guryel, a consultant trauma surgeon based in Brighton, discusses the management of distal femoral bone loss, a complex type of fracture often resulting from severe high-energy injuries. Guryel presents two detailed case studies to illustrate different surgical approaches and outcomes.
The first case involves a 51-year-old male who suffered a contaminated, intra-articular open fracture of the right distal femur after a motorcycle accident. Guryel emphasizes the importance of timely surgical intervention and opts for reconstruction over replacement due to the patient's age and activity level. He explains his surgical technique involving thorough debridement, use of headless compression screws, and a retrograde femoral nail to stabilize the fracture, enabling early rehabilitation. Despite some complications, the patient eventually becomes pain-free with a good range of motion.
The second case addresses a 45-year-old female with multiple injuries, including severe damage to the distal femur. Guryel again performs a primary debridement and uses advanced techniques such as a bone transport nail and synthetic bone grafting to promote healing. This patient also achieves full weight-bearing status and becomes pain-free.
Guryel concludes by discussing the challenges of distal femoral bone loss, emphasizing that modern techniques can significantly improve patient outcomes, reduce complications, and enhance satisfaction compared to older methods involving external fixation devices. The overarching message is one of hope and innovation in the management of complex orthopedic injuries.