Fracture Care · Hip & thigh
Distal femur fracture
Distal Femur Fracture (Thigh Bone Fracture Above the Knee) — Open Reduction and Internal Fixation (ORIF)
The condition
The distal femur is the lower end of the thigh bone, which forms the top of the knee joint. It can break in a high-energy injury or, in older adults with weaker bone, a simple fall, and the break often extends into the knee joint. It causes pain, swelling, and an inability to stand on the leg.
The surgery
Through an incision on the side of the knee (sometimes with smaller extra incisions), the broken pieces are put back in place—especially the joint surface—and held with a plate and screws. Some fractures are better held with a rod (nail) placed through the knee, or with both. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Touch-down weight (foot flat, ~20 lb) with crutches or a walker for 6 weeks; some fractures allow more. After the 6-week x-rays, weight is added over 2–4 weeks.
- Motion
- Knee bending starts right away, with no brace or motion machine: 90° by 2–4 weeks and 110° by 6 weeks. Stationary bike from 4 weeks.
- Daily life
- Desk work often within 2–4 weeks. No driving while taking narcotic pain medication.
- Running
- Typically between 4 and 6 months, once the bone has healed and thigh strength allows.
- Activity
- Full release typically 4–6 months, with good knee motion and a normal walk.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring the alignment and joint surface gives the best chance of regaining knee motion and walking. Risks are uncommon and include infection, blood clots, knee stiffness (the most common problem), the bone healing slowly or not at all, the bone healing out of line, hardware irritation that may require removal, knee arthritis over time, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
Open, save or print. Bring your questions to your pre-op visit.
Before & after every surgery