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The gold standard in treating distal femur fractures is internal fixation, which yields good functional outcome [4-7]. Internal fixation is achieved through locked plating and to a lesser extent through intramedullary nailing, both preferably performed in a minimally invasive manner to preserve the fracture vascularization and improve outcome in fracture healing [8]. Since the introduction of lateral locked plating this technique has become increasingly popular since the first publications showing promising levels of union ranging between 90-100% [8-14]. However, later studies that include more complex fractures due to High Energy Trauma showed higher nonunion rates of up to 20 % [4,15].

Impaired Fracture Healing of the Distal Femur after High Energy Trauma