الفهرس 
ANATOMY OF THE DISTAL FEMUROnly 14 pages are availabe for public view
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Abstract
The management of patients with closed comminuted supracondylar femoral fracture with intact soft tissue and neurovascular state is challenging.
It is important to use a technique that can provide secure fixation with minimum handling of tissues, while allowing early knee mobilization and early partial weight bearing.
Treatment options for fractures range from the various types of Internal to Ilizarov external fixation for displaced or unstable comminuted fractures. The fixation chosen significantly impacts the outcomes of fracture healing. Although rigid fixation is preferable in the treatment of select fracture types, the process of plate fixation can create its own complications. Achieving a rigid plate/bone construct necessitates some degree of soft-tissue stripping and devitalization of the underlying bone. With comminuted fracture patterns, rigid fixation is not desirable, and the use of bridge plating techniques allows for a small amount of fracture site motion, the formation of callus, and indirect fracture healing.
Internal fixation procedures are dependent on fracture type and the surgeon’s preference.
Every internally stabilized fracture represents a race between fracture healing and implant failure there are many balancing forces that affect the eventual outcome.
In recent years, the use of the Ilizarov External Fixator (IEF) has been increasingly adopted for the management of complex intra- or peri-articular fractures of the knee joint.
The Ilizarov external fixator when used for the treatment of comminuted supracondylar and intercondylar fractures of the distal femur has considerable advantages. These are a shorter operating time, low blood loss, minimal surgical exposure, the lack of periosteal stripping with possible quicker healing of the fracture, greater mechanical stability and good knee range of motion.
Conclusion of the result:
In our review we included fifteen studies to compare 361 participants who underwent internal fixation and 48 participants who underwent Ilizarov external fixation in terms of nonunion, fixation failure rate, secondary surgical procedures, deep infection and knee function score. Additionally, the studies’ eligibility criteria were comparatively broad, reflecting the population sustaining this injury.
Based on currently available evidence comparing outcomes of both fixation techniques we conclude that in the presence of a compliant patient and a skilled surgeon Ilizarov external fixation found to be superior to Internal fixation in terms of union and good overall knee lambert score with a significant P-value while found to have similar results to internal fixation in terms of fixation failure rate, secondary surgical procedures and deep infection rate with insignificant P-value.
We recommend the use of an Ilizarov fixator in the treatment of severely comminuted fractures of the distal femur.