Long term results of unicondylar fractures of the femur.

Twenty-four unicondylar fractures of the distal femur were treated at the Trauma Center "Bergmannsheil," University of Bochum, Germany, between 1981 and 1990. All patients sustained their injuries from severe direct trauma. There were 16 lateral condylar fractures, five medial condylar fractures, and three tangential posterior ("Hoffa-type") fractures. Twenty-three closed injuries and one grade IIIB open fracture are included. Nine patients (37.5%) sustained concomitant injuries to the skeleton. All fractures were treated with open reduction and internal fixation with screws within 8 h of admission. Postoperative management consisted of early continuous passive motion and minimal weight bearing for 6-8 weeks progressing to full weight bearing. The mean follow-up was 62 months (24-120). The therapeutic outcome (clinical result, radiographs) was rated by the Neer score. Twenty patients were rated excellent, three achieved satisfactory results, and one had an unsatisfactory result. All patients without an excellent outcome had accompanying injuries. Open reduction and internal screw fixation of unicondylar femur fractures provides overall excellent long-term results. The therapeutic outcome is significantly affected by associated injuries of the skeleton.