High mortality following distal femur fractures: a cohort study including three hundred and two distal femur fractures

Purpose: What are the overall, 30-day, 6-month, and 1-year mortality rates following distal femur fractures? Methods: Epidemiological cohort study. Retrospective reviews of charts and X-rays based on a search in the National Danish Health Registry. Results: A total of 293 patients were treated for 302 distal femur fractures between 2005 and 2010. The mean age at the time of fracture was 44.0 years for males and 71.6 years for females. The overall mortality rates after a non-periprosthetic distal femur fracture at 30 days, six months, and one year were 5%, 15%, and 21%, respectively. The mortality rates for patients at > 60 years at 30 days, six months, and one year were 8%, 26%, and 35%, respectively. The mortality rates for patients at ≤ 60 years at 30 days, six months, and one year were 1%, 2%, and 3%, respectively. The overall mortality rates after a periprosthetic distal femur fracture at 30 days, six months, and one year were 10%, 15%, and 15%. Males were 2.6 (95% CI 1.01–6.86, P = 0.04) times more likely to die within the first year compared to women. Patients treated by conservative means shows a 2.8 (95% CI 1.41–5.54, P = 0.03) times increased likelihood of death within the first year compared to patients treated with surgery. Conclusions: The overall one year mortality rate was 21% for non-periprosthetic distal femur fractures and was elevated to 35% in patients older than 60 years. Patients presenting with a periprosthetic fracture showed a one year mortality rate of 15%.