Oct, 2017 supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. The femur is the largest and strongest bone in the body, so it takes tremendous force to cause a fracture. The number of highenergy traumas causing distal femoral fractures is increasing. Supracondylar femur fracture is a rare but devastating complication. Supracondylar femoral fracture central coast orthopedic. In addition to the t2 femoral nailing system, stryker developed the t2 supracondylar nail scn for the treatment of complex distal femoral fractures. Pdf treatment of resistant nonunion of supracondylar. Surgical treatment of this fracture is used to reduce morbidity, together with. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. The purpose of this study was to analyze the complications and clinical outcomes of lp treatment for distal femoral fractures. Gartlands classification of supracondylar fracture of humerus galeazzi fracture a fracture of the radius with dislocation of the distal radioulnar joint colles fracture a distal fracture of the radius with dorsal posterior displacement of the wrist and hand smiths fracture a distal fracture of the.
Garden city hospital 1998 introduction 47% of all femur. Jan 10, 2016 summary every surgically managed fracture is a race between bony union and implantbiological failure leading to nonunion. In case of young people, it occurs due to highenergy trauma. Infection can occur, requiring antibiotics and further treatment. Supracondylar humeral fracture radiology reference. The backslab and sling should be placed under figure 2. Supracondylar fracture definition of supracondylar fracture. Distal femur fractures indirect reduction not for articular surfaces direct visualization and reduction preserves softtissue envelope around metadiaphyseal.
Supracondylar fractures are the most common type of upper arm injury in children. This injury can involve the cartilage on the base of the femur in the knee joint, and may increase the risk of developing knee arthritis later in life. No loc, helmet on, unable to ambulate 22 severe right knee and thigh pain. Distal femur lecture orthopaedic trauma association. The proximal femoral fracture in the elderly is a serious public health problem.
Ppt distal femur fractures powerpoint presentation free. Fracture, femoral shaft childrens hospital colorado. Exclusion criteria were pathological fracture, periprosthetic fracture of the knee, child younger than 15 years and 3 months, and epiphyseal separation. Midshaft femur fracture all subtrochanteric pediatric hip pain. But when nonunion occurs, it becomes a challenging task for the surgeon and patient both. Supracondylar femur fractures clinical presentation.
The socalled hoffa fracture refers to an isolated, coronallyoriented fracture of either femoral condyle, with intraarticular extension. Unicondylar fractures of the distal femur emconsulte. It take a great deal of force to break the thigh bone. These fractures are more commonly seen in boys 4 these injuries are almost always due to accidental trauma, such as falling from a moderate height bedmonkeybars 4. Thighbone femur fractures in children ortho 4 states. Distal femur fracture ao type a and c1, open wound around the knee, bilateral femur fractures, ipsilateral segmental fracture and severe obesity. Unreamed antegrade unreamed nailing was performed with protection of the proximal fragment with cerclage wires.
Pt was riding on a country road when he accidentally hit an obstacle and was ejected from his motorcycle. Supracondylar femur fracture orif ostrum 2 years ago this video demonstrates the approach, reduction, and internal fixation of an intraarticular supracondylar distal femur fracture with a hoffa fracture using a distal femoral locking plate. The most common cause of a fracture is direct trauma to the leg from an automobile accident or a fall. Fractures of the distal femur whether supracondylar. Early weight bearing on supracondylar distal femur fractures. This rare injury corresponds to the orthopaedic trauma association type 33b3 fracture frontal, partial articular fracture of the distal femur. This study aims to compare their mortality rates and assess whether surgical intervention improves either outcome or mortality following distal femoral fractures.
A supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. Krishnamoorty summary a retrospective study of 34 patients with. With intercondylar split fracture patterns, the two heads may also cause the distal condylar fragments to separate and rotate. A femoral fracture is a bone fracture that involves the femur. Supracondylar femur fractures orthopaedicsone articles. Supracondylar fractures are most common in patients who suffer from osteoporosis or have had total knee replacement surgery. In general, casts and braces can hold fractured bones in place as you heal. The incidence of supracondylar fracture after total knee arthroplasty is approximately 1%.
Distal femur fractures orthopaedic trauma association. Fractures of the distal femur the supracondylar fracture distal femur fractures j. A satisfactory result based on modified mize criteria was achieved in 50 % of supraintercondylar fractures and in 79. Risks of a fractured femur there are risks and complications with this procedure. This condition is a break in the femur at the knee joint. Patients with supracondylar fractures will often have prolonged period months of inability to fully extend their elbow. Treatment is usually closed reduction and percutanous pinning crpp, with the urgency depending on whether the hand remains perfused or not. Despite technique suggestions from anecdotal and some early reports, knowledge about risk factors for failure, nonunion nu, and revision is limited. Outcome of retrograde intramedullary nailing and locking. Sickkids parent information sheet supracondylar humerus fracture without displacement. May 04, 2016 the b3 type fracture popularly known as hoffas fracture has immense clinical signifcance in the outcome following treatment and has been further subdivided into three types 3,8,10. On the ap view, fracture lines can be seen through the metaphyseal bone of the distal humerus on either side of the olecranon fossa. Nail will not have an isthmic fit may need blocking pinsdrill bitsscrews percutaneous or open clamps nail will lock a fracture in a malreduced position as easily as it will. These fractures usually occur in elderly patients with multiple comorbidities and osteoporotic bone.
This type of fracture is associated with the injuries of the pelvis, hip, and knee, and considered as the major crack in the thigh bone. Cross pinning technique used to stabilize supracondylar fracture of femur adversely affects flexion angles of stifle joint leading to joint stiffness compared to either of the end threaded pinning. Nonphyseal supracondylar fractures of the femur are considered to be uncommon in children and have received little attention in the literature. Supracondylar medical definition merriamwebster medical. The purpose of this paper is to report the use of total knee arthroplasty, a megaprosthesis, as a treatment in elderly patients who have a persistent nonunion of a supracondylar femur fracture. At latest followup, 9 month after the injury, uneventful healing of the femur fracture had occurred. Open supracondylar fracture of femur short description. Distal femur fractures represents about 7% of all femur fractures in adults, and are notoriously difficult to treat. The fracture line was sagittal in 82% of cases and coronal hoffa fracture in.
Femoral shaft fractures orthopaedic trauma association. This type of cornoal fractures of he distal femur are further classified into. Supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles.
A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. Dec 07, 2015 the socalled hoffa fracture refers to an isolated, coronallyoriented fracture of either femoral condyle, with intraarticular extension. Raise the arm on a pillow when sitting or lying down loose fitting clothing, not through the sleeve. Dec 18, 2017 a supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow.
A new anterolateral approach for type c fractures of the distal femur. The anatomy of the distal femur explains the three major types of fracture. The fracture line was sagittal in 82% of cases and coronal hoffa fracture in 18% of cases. As the most commonly fractured long bone, it is not surprising that the femur was the first bone in which internal fixation was attempted. Currently this cohort is not afforded the same resources as those with hip fractures. Pediatric supracondylar fractures are one of the most common traumatic fractures see in children and most commonly occur in children 57 years of age, usually from a fall on an outstretched hand. Timing of femoral shaft fracture fixation affects length of hospital. Because of the anatomy of the distal femur, only surgical treatment is indicated to stabilize the fracture.
Ota video library supracondylar femur fracture orif. The best suitable fda approved implant for a particular fracture pattern of distal femur was used. Thighbone femur fractures in children the thighbone femur is the largest and strongest bone in the body. Physical therapy in the postoperative of proximal femur fracture in. The lateral cortex of the femur has a 10 degree slope, and the medial cortex slopes 25 degrees.
Management of fractures of distal femur journal of medical. Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. A free powerpoint ppt presentation displayed as a flash slide show on id. Locked plating lp of distal femoral fractures has become very popular. Casts and braces may not work well with this type of fracture, unless it is stable and the bone pieces are well aligned. Supracondylar distal femoral nonunions treated with a megapr. The lateral and medial condyles were equally affected. Use of cbps for supraintercondylar and supracondylar femur fractures treatment led to a high union rate.
Chapter 53 fractures of the distal femur china quad diaries. The normal anatomic axis of the distal femur is 6 to 7 degrees of valgus in a male and 8 to 9 degrees in a female. Early weight bearing on supracondylar distal femur fractures in elderly patients the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Summary every surgically managed fracture is a race between bony union and implantbiological failure leading to nonunion. This does not cause functional disability and should not be treated with physiotherapy. It tends to occur in osteoporotic bones in the elderly due to lowenergy trauma. Femur fractures are common among trauma patients and are typically seen in patients with multiple injuries resulting from. They are caused by a direct impact on the flexed knee during weight bearing. The most common mechanism is an indirect trauma on a bent knee, and more rarely direct trauma by crushing. Ppt fractures of the distal femur powerpoint presentation. If the fractures around hip are excluded, 31% femoral fractures involve distal portion 1. Pt landed on a flexed right knee and rolled over to the right side on the ground. Supracondylar humeral fractures are the second most common fracture type in children.
But with supracondylar femoral fracture, the muscles in the thigh often contract and pull the bone pieces apart. Any pathological fracture except due to osteoporosis method of study every patient was evaluated after history, clinical examination and radiological investigation and fracture pattern was classified according to ao classification. Supracondylar fractures of the femur 33a, b, and c. It can break when a child experiences a sudden forceful impact. To study the incidence and pattern of supracondylar femur fractures according to aoasif classification, to assess the treatment and longterm functional outcome for supracondylar femoral fracture using retrograde nail. Gartlands classification of supracondylar fracture of humerus. Management of acute distal femur fracture with a nail or plate has good union rate or more than 90%.
Optimal timing of femur fracture stabilization in polytrauma patients. Cause statistics the most common cause of thighbone fractures in infants under 1 year old is child abuse. Distal femur fractures and its treatment with distal femur. Hoffa fracture of the femoral condyle pubmed central pmc. Unicondylar fractures of the distal femur sciencedirect. Schatzker j, horne g, waddell j 1974 the toronto experience with the supracondylar fracture of the femur 19661972. There are different kinds of breaks, from simple to serious. Listing a study does not mean it has been evaluated by the u. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Lateral and ap view of two year old girl with gartland type ii supracondylar fracture. The fracture can range from a small crack to a full break that allows part of the bone to separate. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b.
The fracture line starts in the lateral or medial intercondylartrochlear groove. Clinical outcomes of locked plating of distal femoral. A comparison of mortality following distal femoral fractures. The fracture was due to a highenergy trauma in 51% of cases. On lateral view the anterior humeral line is anterior to the middle of capitellum.
Patients with unicondylar fractures of the distal femur were included. Indications for retrograde im nailing for the treatment of distal femur fractures include 16,19,21,22. Distal femur fractures and its treatment with distal femur locking plate kanav padha, sandeep singh, abdul ghani, harish dang the incidence of distal femur fractures is around 37 100,000 patients per year. Distal femur fracture, new anterolateral approach, anatomy. Comparison of supraintercondylar and supracondylar femur. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. Pdf supracondylar fracture of the femur in children. This case report includes two elderly patients who sustained supracondylar femur fractures that failed to unite with standard operative fixation methods. The femur is the largest and strongest bone in the body.
1594 544 917 1206 904 438 1369 1025 218 1201 1511 1558 976 1285 1221 512 27 489 28 835 1508 769 22 703 731 292 57 58 370 253 431 331 1655 480 246 864 1461 1490 1102 1240 428 935 1353 123 1454