Much has been written about the use of different treatment modalities in the management of distal femoral fractures. These articles, however, do not include the use of the Ilizarov frame amongst the modalities described. We have experience in the use of the Ilizarov frame in the definitive treatment of both non-union and acute fracture of the distal femur. We report our experience and conclusions.

The medical records of all patients who had undergone Ilizarov frame management for acute distal femoral fracture or established non-union were reviewed. Demographic data, the complications of surgery, duration of treatment with the frame and recorded outcome were noted. All patients were further assessed (either in clinic or by telephone interview) and completed a Short Musculoskeletal Function Assessment Form.

We have treated 17 patients (11 male, 6 female), 8 were acute compound fractures and 9 non union/infected ORIF’s of the distal femur. All patients have had their frames removed and were united. The mean age at the time of frame application was 36.6 years (range 18.7–58.7). The mean time from frame application to union was 230 days (range 81–514). Noted major complications included refracture in two patients, persisting infection in one, chronic regional pain syndrome in one and limited range of movement in all (mean knee movement of 62 ranging from 2–100). Two patients have had above knee amputations and a further patient has requested above knee amputation. Short Musculoskeletal Function Assessment Form shows significant dysfunction with a mean score of 42.9/100 (range 8.15–82.85).

Treatment of distal femoral fractures is notoriously difficult. Other treatment modalities (i.e. Intra Medullary (IM) supracondylar nail) offer many advantages over Ilizarov frame use.