Strategies for Preventing Malreduction in Distal Femoral Comminuted Fractures: A Case Report Publisher



Zolghadr H ; Soleymani M
Source: Journal of Orthopedic and Spine Trauma Published:2026

Abstract

Background: Comminuted distal femur fractures pose a significant challenge to achieving precise reduction and stable fixation. Achieving proper alignment is critical, as malreduction can lead to functional impairment and altered gait. Careful preoperative planning and precise intraoperative technique are essential to optimize fracture reduction and ensure favorable postoperative outcomes. Case Report: A 39-year-old man sustained a comminuted distal femur fracture [AO Foundation/Orthopedic Trauma Association (AO/OTA) 33-C2] after a 9-meter fall. Surgical fixation was performed one week later using a precontoured anatomic lateral locking plate via minimally invasive plate osteosynthesis (MIPO). Postoperative imaging demonstrated a recurvatum deformity of the knee. At three months, fracture union was achieved with functional knee motion. This case underscores careful planning and implant positioning in complex distal femur fractures. Conclusion: Optimal management of comminuted distal femur fractures requires precise anatomical reduction, careful plate positioning, and intraoperative verification to restore alignment, length, and rotation, while avoiding intercondylar notch violation. Immediate correction of malposition is essential to prevent postoperative deformity and preserve function, even if it modestly prolongs operative time. © 2026 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.