Swashbuckler approach for distal femur fractures: A systematic review

Balgovind S Raja; Aditya K S Gowda; Bibin K Baby; Sunny Chaudhary; Pradeep Kumar Meena

doi:10.1016/j.jcot.2021.101705

Swashbuckler approach for distal femur fractures: A systematic review

J Clin Orthop Trauma. 2021 Nov 19:24:101705. doi: 10.1016/j.jcot.2021.101705. eCollection 2022 Jan.

Authors

Balgovind S Raja¹, Aditya K S Gowda¹, Bibin K Baby², Sunny Chaudhary¹, Pradeep Kumar Meena¹

Affiliations

¹ Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
² Consultant Orthopaedic Surgeon, Indo American Hospital, Vaikom, Kerala, India.

Abstract

Purpose: The review aims to reach a common consensus regarding the swashbuckler approach for distal femur fractures by a systematic review of the available literature and to evaluate the complications, union, and outcomes.

Methods: Electronic database search engines like Cochrane Library, PubMed, Google Scholar, and Scopus were searched until May 2021. Studies comparing the clinical complications, and functional outcome scores of Swashbuckler approach for distal femur were considered. The quality of the articles were evaluated using Methodological Index for Non-Randomized Studies score.

Results: Eleven studies were included for the final analysis. An anterior midline incision was used in the majority of studies. Superficial infection was the most common complication seen followed by knee stiffness and deep infections. 66.45% of the patients had excellent/good outcomes. 1.08% had a painful implant and 1.89% had deep infection.

Conclusion: Swashbuckler approach offers itself as a viable option in cases of distal femur fractures, especially in AO type C. The quadriceps sparing approach provides excellent/good outcomes in approximately 66.45% of the patients.

Keywords: Distal femur fracture; Functional outcomes; Lateral parapatellar approach; Swashbuckler.