Fractures of the femur in cattle are second in frequency only to fractures to the metacarpal and metatarsal bones. This study was aimed to find the effectiveness of dynamic condylar screw in treating closed supracondylar fracture of femur. Ilizarov external fixation for severely comminuted supracondylar and intercondylar fractures of the distal femur. Fracture of shaft femur knee musculoskeletal system. Two patients had a groupi fracture and five, a groupii fracture. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. Frequencyfrequency fractures of the femoral shaft arefractures of the femoral shaft are the most common fractures thatthe most common fractures that orthopedist see.
Femoral lock plant alone for ipsilateral subtrochanteric, supracondylar, and intercondylar fracture author. The knees are the largest weight weightbearing joint in your body. Handbook of fractures pdf latest edition free download ebook. Supracondylar humeral fractures are a common paediatric elbow injury, but are almost never seen in adults the peak age of incidence is 57 years. Delayed surgery for neck of femur fractures nofs beyond.
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. Supracondylar fractures are most common in patients who suffer from osteoporosis or have had total knee replacement surgery. Biomechanics of the fractured femoral neck the new bdsf. Intramedullary nailing is contraindicated in fracture shaft femur if a the fracture is compound b the fracture is near the knee joint c the epiphysis have not fused d any of the above is present e none of the above is present ans. The influence of a onestep reamerirrigatoraspirator technique on the intramedullary pressure in the pig femur. Ostrum, md cooper hospital university medical center camden, new jersey femur fractures common injury due to major violent trauma 1 femur fracture 10,000 people more common in people 65 yo femur fracture leads to reduced activity for 107 days, the average length of hospital stay is 25 days motor vehicle. Femur fracture following acl reconstruction has been reported in isolated cases as a result of distal femoral bone defects created for extraarticular fixation of a goretex prosthetic graft, 9 a ligament augmentation device, 10 iliotibial band tenodesis, 11 doublebundle reconstruction, or femoral postfixation. Treatment is usually closed reduction and percutanous pinning crpp, with the urgency depending on whether the hand remains perfused or not. If treated quickly, either by immobilizing with a cast or. Hastings summary the use of a modified nail plate in the management of supracondylar and intercondylar fractures in.
In this study of 102 femoral fractures, there was an incidence of 12% of supracondylar fractures. The femur is the largest and strongest bone in the body, so it takes tremendous force to cause a fracture. A case of severely comminuted femoral supracondylar fracture successfully treated with nonvascular fibular graft. Evaluate the ipsilateral hip for dislocationinjury evaluate the popliteal fossa for hard signs of vascular injury. The lower part of the knee joint is the shin bone, or tibia tihbeeuh. Supracondylar fracture definition of supracondylar. Pdf use of a supracondylar nail for treatment of a.
Supracondylar fractures in children final authorstream presentation. Supracondylar fracture pediatric pediatrics orthobullets. A fracture that is proximal to the femoral shaft and not appropriate for the application of a supra condylar plate can be defined as a femur shaft fracture. Pdf supracondylar fracture of the femur in children. The answers can be found at the end of the article, together with an explanation. Distal femoral fractures pose a difficult problem for the surgeon with significant complication rates and generally unsatisfactory results. Nail will not have an isthmic fit may need blocking pinsdrill bitsscrews percutaneous or open clamps nail will lock a fracture. Femoral shaft fractures orthopaedic trauma association. Open supracondylar femur fractures with bone loss in the. Bdsf is mainly addressed to patients, who have contraindications for arthroplasty, as well as for conventional screw fixation. Supracondylar fractures in children final authorstream. Posteromedia l vs posterolateral biceps tendon insertion and axis of muscle pull lies medial to the shaft of the humerus during fall onto an outstretched supinated arm, the forces applied tend to disrupt the posteromedial periosteum first and. Distal femur fracture an overview sciencedirect topics.
The most common cause of a fracture is direct trauma to the leg from an automobile accident or a fall. Supracondylar fracture teachmesurgeryteachmesurgery. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Treatment options, prognosis, postoperative complications are discussed for conservative therapy and for various forms of external and internal fixation. The distal femur is usually shattered and the joint can be involved. Conflict of interests e authors declare that there is no con ict of interests. Case report retrograde intramedullary nailing with a. Concomitant injuries associated with femoral shaft fractures.
Increased risk of periprosthetic femur fractures associated. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Use of a supracondylar nail for treatment of a supracondylar fracture of the femur following total knee arthroplasty. Is there a standard rehabilitation protocol after femoral. Although designed to fit the supracondylar region of the femur, we had no difficulty in applying the. Supracondylar femur fracture above a wellfixed posterior cruciate. Sixteen elderly patients with displaced femoral neck. These fractures were surgically treated by ao principles and fixation, and the surgery performed mainly by the two authors.
Gartlands classification of supracondylar fracture of humerus. Supracondylar fracture of the femur is a complicated injury. As a result, they are typically comminuted or involve osteoporotic bone. Femoral lock plant alone for ipsilateral subtrochanteric. Supracondylar humerus fractures figures 1436 through 1440 and 1442 are rare in adults, accounting for only about 3% of adult fractures. Treatment of intertrochanteric fractures of the femur. Supracondylar fractures of the femur in the elderly. Minimally invasive techniques for plate osteonsynthesis have been widely used 19 21 because of the advantages they provide in minimising softtissue damage and preserving the blood. In children, these fractures are more common and can be difficult to diagnose because of skeletal immaturity. Supracondylar and intercondylar fractures of the femur. Thorough initial debridement and early definitive fixation halt ongoing soft tissue injury, restores length and alignment, and allow for sterilisation of the wound.
We report an 82yearold woman who underwent fixation with a longspanning cableplate for a bisphosphonateinduced vancouver b1. Common clinical presentations and the diagnosis of femur fractures are described. Surgical treatment of femoral shaft fractures with an im nail is considered the standard of care with union rates between 95% and 99%, despite this success, functional limitations and impairments often persist after the injury and surgical procedure, which may result in residual disability. Most common type of supracondylar fracture is a extension type b flexion type c abduction type ans. Four of 12 patients had a significant predisposing musculoskeletal condition contributing to the. Timing of femoral shaft fracture fixation affects length of hospital stay in patients with multiple injuries. Nine patients had groupiii fractures of which three were open and six needed cancellous bone grafts to fill bone defects present after anatomical reduction. Operative treatment of supracondylarcondylar fractures of. The most common mechanism of injury is falling on an outstretched hand with the elbow in extension a small percentage occur from landing directly onto a flexed elbow due to the close proximity of. These fractures usually occur in elderly patients with multiple comorbidities and osteoporotic bone. Anterior femoral notching and ipsilateral supracondylar. Current concepts 598 journal of the american academy of orthopaedic.
Supracondylar femur fractures clinical presentation. Supracondylar femoral fracture central coast orthopedic. Supracondylar femur fractures above an insallburstein cck. Supracondylar humeral fracture radiology reference. Healing of open supracondylar femur fractures with critical sized bone defects requires diligent surgical timing in order to optimise the host and wound bed. Distal femur supracondylar fracture everything you need. Pdf ilizarov external fixation for severely comminuted. Supracondylar nailing for difficult distal femur fractures. Ppt supracondylar fractures of the femur powerpoint. Always check the web space between the 1st and 2nd toe. Injury, 5, 259264 259 supracondylar fractures of the femur in the elderly.
Joshua broder md, facep, in diagnostic imaging for the emergency physician, 2010. The distal femur forms the top part of the knee joint. Supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. Supracondylar humerus fractures supracondylar humerus fractures flexion typeflexion type rare, only 2%rare, only 2% distal fracture fragmentdistal fracture fragment anterior,flexedanterior,flexed ulnar nerve injury higherulnar nerve injury higher incidenceincidence reduce with extensionreduce with extension 78. Direct violence, the fracture line above the condyles and may extend between them or may be severely comminuted. Supracondylar sooprukondilar femoral fracture also called a distal distuhl fracture is when the thigh bone, or femur, is broken at the knee. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. 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. Rationale for reduced pressure reaming when stabilizing actual or impending pathological femoral fractures. Supracondylar fracture of the humerus is a common childhood injury to the elbow. Anterior femoral notching and ipsilateral supracondylar femur fracture in total icanee arthroplasty m e r r i l l a. Oblique sc fracture of a patient with hxo prosthetic knee.