Over a period of twenty years, 442 patients with fractures in the distal third of the femur were treated and studied. Of these, 213 were followed for one year or longer, and their final results are reported. The results of various methods of treatment are compared. The current popular methods of surgical repair are discussed, and most of these are condemned. Two-pin traction, using 3/32-inch, smooth Kirschner wires and spreaders, is recommended as the treatment of choice.
Early active exercise of the muscles of the thigh while the limb is in traction is strongly recommended. Active exercise prevents adhesions and fibrosis, the primary causes of restriction of knee and quadriceps motion.
Of the 213 patients followed for one year or more, nineteen had non-union and fifteen had delayed union. The causes of faulty union and the results of its treatment are discussed. All patients in whom death occurred or amputation was carried out are discussed.