Distal femoral fractures pose a difficult problem for the surgeon with significant complication rates and generally unsatisfactory results. The femoral neck is the most common location for a hip fracture. Chapter 53 fractures of the distal femur china quad diaries. This condition is a break in the femur at the knee joint. Transcondylar fracture definition of transcondylar. Methods eight human cadaver femoral shafts were transected approximately at midshaft after which a tsupracondylar fracture was created via osteotomy. Distal femur fractures include fractures of the supracondylar and. This is done either with manual traction or if neces. Lcp posterolateral distal humerus plates, with support and lcp medial distal humerus plate duration. A supracondylar femur fracture, also called a distal femur, is an unusual injury that occurs just above the knee joint. Oct, 2017 supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. Surgical treatment of supracondylar fractures of the femur has become commonplace. It take a great deal of force to break the thigh bone. Open reduction of transcondylar fracture of femur without intercondylar extension, with internal fixation.
Open reduction of supracondylar fracture of femur without intercondylar extension, with internal fixation. Distal femur fractures indirect reduction not for articular surfaces direct visualization and reduction preserves softtissue envelope around metadiaphyseal. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. Complications of surgically treated supracondylar fractures of the femur. Supracondylar femur fractures orthopaedicsone articles.
Weight bearing is generally restricted for 6 to 12 weeks until radiologic evidence exists of. Open supracondylar fracture of femur short description. Distal humerus fractures of the elbow orthoinfo aaos. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which require vigilance as imaging findings can be subtle. Republican research centre of emergency medicine rrcem, tashkent, uzbekistan. Jan 06, 2017 lcp posterolateral distal humerus plates, with support and lcp medial distal humerus plate duration. We classify transcondylar fractures of the distal humerus into four groups. Winquist classification of femoral shaft fracture i.
Overview of the femur and pelvis fracture episode of care. A satisfactory result based on modified mize criteria was achieved in 50 % of supraintercondylar fractures and in 79. A ct scan is obtained which shows intraarticular extension of the fracture, and lateral locked plating with intercondylar lag screw fixation is planned. Understanding the anatomy, radiographic findings, complications, and management options associated with this fracture allow physicians to limit the morbidity associated with this injury. A fracture in this area can be very painful and make elbow motion difficult or impossible. Supracondylar femur fracture adult distal femur trauma options. Transcondylar definition of transcondylar by 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. Pt was riding on a country road when he accidentally hit an obstacle and was ejected from his motorcycle. Pdf current concepts in fractures of the distal femur. Ppt distal femur fractures powerpoint presentation. Pelvis fracture patients will receive open reduction with internal fixation, utilizing plates and screws. They are caused by a direct impact on the flexed knee during weight bearing. Supracondylar fractures of the femur sciencedirect. We found in our series of 11 patients that undisplaced fractures have the best. Supracondylar fracture pediatric pediatrics orthobullets. Answer orif with intramedullary nail of supracondylar. Transcondylar distal humerus fracture with capitulum fracture in a pediatric patient article pdf available may 2019 with 97 reads how we measure reads. Unicondylar fractures of the distal femur sciencedirect.
Newman bristol royal infirmary, bristol, uk introduction fractures at the upper end of the femur are occurring with everincreasing frequency and have now reached epidemic proportions boyce and vessey, 1985. Toronto experience with supracondylar fractures from. Femur fracture classification aoota femur diaphysis bone segment 32. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. Distal femur fractures occur in a bimodal distribution, with highenergy traumatic injuries in younger patients and lowenergy mechanisms in older patients with poor bone quality. Transcondylar definition of transcondylar by medical dictionary. The full text of this article is available in pdf format. Right humerus transcondylar upper arm bone fracture. Nov 19, 2018 condylar and subcondylar fractures constitute 2640% of all mandible fractures see the image below.
Krishnamoorty summary a retrospective study of 34 patients with. Gartlands classification of supracondylar fracture of humerus. Pdf treatment of gustilo grade iii b supracondylar. Transposition of the ulnar nerve allows us to use the cubital tunnel as a point for fixation. Management of distal femur fractures in adults orthopedic clinics.
Supracondylar fractures are the most common type of upper arm injury in children. But with supracondylar femoral fracture, the muscles in the thigh often contract and pull the bone pieces apart. We treated 87 patients with supraintercondylar or supracondylar femur fracture from 2004 to. The code is valid for the year 2020 for the submission of hipaacovered transactions. Open reduction of supracondylar fracture of femur with intercondylar extension. Pdf supracondylar fracture of the femur in children. Type iv simple sus and intercondylar fractures were the most common in 35. Pt landed on a flexed right knee and rolled over to the right side on the ground.
Twenty patients who had been treated with ilizarov external fixation for a gustilo grade iiib supracondylar fracture of the femur were functionally assessed 12 to 52 months after treatment. 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. Examples of indirect reduction methods include manual traction, pointed. Humerus transcondylar and intercondylar fracture youtube. A free powerpoint ppt presentation displayed as a flash slide show on id. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Use of cbps for supraintercondylar and supracondylar femur fractures treatment led to a high union rate. Aug 01, 2012 comminuted supracondylar femur fractures aoota 33a3 are commonly treated with locked plates. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. As depicted in exhibit 1, the patient journey begins when a patient experiences signs and symptoms of a femur or pelvis fracture e. Overview this condition is a break in the femur at the knee joint.
Dec 18, 2017 a supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. Supracondylar humeral fracture radiology reference article. No loc, helmet on, unable to ambulate 22 severe right knee and thigh pain. The lateral cortex of the femur has a 10 degree slope, and the medial cortex slopes 25 degrees. The long, straight part of the femur thighbone is called the femoral shaft. Our trauma registry was queried for adult distal humeral fractures that were treated surgically between 1996 and 2010. The incidence of supracondylar fracture after total knee arthroplasty is approximately 1%. May 10, 2008 supracondylar fractures of the humerus are a common pediatric elbow injury that can be associated with neurovascular complications and skeletal deformity. 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. Risks of a fractured femur there are risks and complications with this procedure.
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. Immediate weight bearing of comminuted supracondylar femur. Infection can occur, requiring antibiotics and further treatment. 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. Stabilization of these fractures is difficult because the distal fragments are small and a large portion of their surface is covered with articular cartilage. Supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. Includes transcondylar, supracondylar, intercondylar, and capitallar fractures classification ao type extraarticular partial intraarticular complete intraarticular treatment use closed treatment for undisplaced minimally displaced fracture use orif f. These fractures usually occur in elderly patients with multiple comorbidities and osteoporotic bone. Orif of supracondylar region of femur doesnt normally take place unless there is a fracture, and is not necessarily a part of revision of tkr.
Open reduction of transcondylar fracture of femur with intercondylar extension, with internal fixation. Among the eight patients with healed fractures after sufficient followup, patients with higher extraarticular distal humerus fractures had better motion and function than patients with low transcondylar fractures. Butterfly fragment involves more than 50% of the bone width iv. As a result, they are typically comminuted or involve osteoporotic bone. Casts and braces may not work well with this type of fracture, unless it is stable and the bone pieces are well aligned. In general, casts and braces can hold fractured bones in place as you heal. Fractures of femur, close to or involving condyles, are common and constitute about 30% of total femoral fracturers in dogs alcantara and stead, 1975.
These fractures often involve the cartilage surface of the knee joint and are most commonly seen in people with severe osteoporosis or those who have previously undergone total knee replacement surgery. Basically, my doctor treated a supracondylar distal femur fracture with intercondylar extension by both orif w plate, screws, and kwires and also an im nail. Supracondylar and intercondylar fractures of the femur. Supracondylar soopruhkondehlahr femoral fracture also called distal distuhl femur fracture is when the thigh bone breaks at the knee. Femur shaft fractures broken thighbone orthoinfo aaos. There are different kinds of breaks, from simple to serious. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Three commonly used implants implants a, b and c are shown in figures a, b and c respectively. Among the nine patients with low transcondylar fractures, two had nonunion and three died within 3 months of injury. Butterfly fragment is large but there is still 50%of cortical intact between the main fragments iii. Most distal humerus fractures are caused by some type of highenergy eventsuch as receiving a direct blow to the elbow during a car collision.
Pdf on may 20, 2019, rishit jayesh soni and others published transcondylar distal humerus fracture with capitulum fracture in a pediatric patient find, read and cite all the research you need. The fracture line starts in the lateral or medial intercondylartrochlear groove. Links to pubmed are also available for selected references. Treatment tactics of transcondylar and supracondylar. Undisplaced fractures are treated with immobilization. Femoral shaft fracture patients will receive intramedullary nailing. Fourteen fractures were type c3 and 6 were type c2 according. Comparison of supraintercondylar and supracondylar femur. Supracondylar femoral fracture central coast orthopedic.
Pdf this paper describes current treatment strategies of distal femoral fractures as well. Epidemiology simple supracondylar fractures are typically seen in yo. Femoral neck fractures and peritrochanteric fractures are equally prevalent and make up over 90 percent of proximal femur fractures. This procedure is the fixation of the thighbone femur using a nail, plate, rod and screws. Treatment tactics of transcondylar and supracondylar fractures of humerus complicated by peripheral circulation disturbances in children. Unicondylar fractures of the distal femur are rare lesions, that often occur in combination with other posttraumatic injuries and may therefore fail to be recognised initially. In an older person who has weaker bones, however, even a minor fall may be enough to cause a fracture. Your hip is a ball and socket joint where your upper leg meets your pelvis. Distal femur, fracture, supracondylar and intercondylar fracture, internal fixation, biomechanics. Get a printable copy pdf file of the complete article 2. Please tell us where you read or heard it including the quote, if possible. We help you diagnose your distal femur case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Abstract the article is devoted to uptodate diagnostic methods and surgical correction of transcondylar and.
Current procedural terminology open treatment of femoral. Transcondylar medical definition merriamwebster medical. These fractures were surgically treated by ao principles and fixation, and the surgery performed mainly by the two authors. But, orif has already taken place, and the tkr is performed at both femoral and tibial component as per descriptiion, so we should code for the both. Ppt distal femur fractures powerpoint presentation free. Our treatment of these fractures is based upon this classification. Pediatric supracondylar fractures of the distal humerus. Transcondylar fracture definition of transcondylar fracture. The pin is fixed directly to the orthopaedic table by an adaptable stirrup, and traction is applied until anatomical reduction in the ap view is obtained fig. This is a retrospective case study of the outcome of a series of patients with low transcondylar fractures of the distal humerus treated by open reduction and internal fixation.
The femur is the largest and strongest bone in the body. Femoral shaft fractures orthopaedic trauma association. Complications of surgically treated supracondylar fractures. Pdf transcondylar distal humerus fracture with capitulum. Femur fracture leads to reduced activity for 107 days, the average. Transcondylar fractures of the humerus in children. The fracture can range from a small crack to a full break that allows part of the bone to separate.
232 1126 153 820 1598 754 1451 1384 462 1597 861 1024 397 923 256 203 963 231 895 316 1054 1099 370 712 1370 1210 987 1099 225 870 355 1590 414 1529 1179 802 1121 1316 1175 37 1275 711 173