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. Open management was used for 32 of the fractures with good to excellent results in 81%, while a. The fractures were classified by the asif system, with c1 being a simple y pattern, c2 having additional supracondylar comminution, and c3 having intraarticular comminution. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Supracondylar fractures of femur have a bimodal age distribution, with a high incidence in young adults from high energy trauma, such as motor vehicle accidents and a second peak in elderly with minor fall 2,3. Extra capsular intertrochanteric subtrochanteric shaft distal end supracondylar condylar. Pre op xray anteroposteriorap and lateral xray of thigh. Backgroundperiprosthetic supracondylar fractures in the setting of an ipsilateral total knee and hip replacement are a rare but serious orthopedic challenge. Analysis of femoral fracture post motor vehicle accidents finnegan 1978.
Retrograde nailing, distal femur fractures, neers scoring 1. Epidemiology and treatment of distal femoral fractures in adults. Open supracondylarintercondylar fractures of the femur. Retrograde intramedullary nailing for periprosthetic. Pdf surgical management of distalsupracondylar fracture. Most common type of supracondylar fracture is a extension type b flexion type c abduction type ans. Supracondylar fracture of the femur after total knee arthroplasty. The distal femur forms the top part of the knee joint. Immediate weight bearing of comminuted supracondylar femur. Fixation of periprosthetic supracondylar femur the. These fractures are more commonly seen in boys 4 and are the most common elbow fractures in children 5580% 8 these injuries are almost always due to accidental trauma, such as falling from a. Periprosthetic supracondylar fractures of the femur after total knee arthroplasty are not.
Th is study was undertaken to analyze the clinical outcomes of retrograde intramedullary nailing for periprosthetic supracondylar fractures of the femur after total knee arthroplasty and examine the efficacy of. This is important to ensure an optimal outcome and reverse any strength or flexibility losses that quickly occur with immobilisation. The indications of a medial plate in addition to the lateral plate are medial supracondylar bone loss, low transcondylar bicondylar fractures. A study on functional outcome of comminuted supracondylar. Reimplantation of an extruded femoral segment after gamma. Outcome of supracondylar femur fracture in adults managed by.
It account for less than 7% of all femur fractures 1. These fractures occur in the distal metaphyseal region of the femur together with condylar fractures, either as an isolated or a comminuted fracture 7. He had sustained type iiia open supracondylar fracture of the right femur ota 33a3. They result from force applied across the elbow, usually following a fall. Diagnosis of the right femoral supracondylar nonunion was made based. Apr 01, 1999 the most frequently encountered fracture occurring in juxtaposition to a total knee replacement is a supracondylar fracture of the femur. The final results were rated using the system that was described by neer et al.
Fixation of periprosthetic supracondylar femur the indirect. Flowstone fs whip mix, louisville, ky in an aluminum cup allowing for. Gartlands classification of supracondylar fracture of humerus. Subset of 20 sif open fractures treated with tsf extracted from a consecutive series of 80 sif fractures treated between 2007 and 20. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. Satisfactory results pain free knee without angular deformity and at least 90 of. The outcomes of locked plating and intramedullary im nail fixation were therefore compared based on fracture location, being above or atbelow the total knee arthroplasty tka flange. An unusual case of locking of the knee four years post. The treatment of supracondylar and diaphyseal femoral. Weight bearing is generally restricted for 6 to 12 weeks until radiologic evidence exists of. Neer knee scores were 21% excellent, 68% good, and 11% fair. He sustained a gustillo iiia ao type 33c3 left supracondylar femur fracture and a verticalsplit fracture of his patella.
It take a great deal of force to break the thigh bone. Fiftyone cases of supracondylar fracture of the femur with a mean followup of 29 months were retrospectively studied. Supracondylar fractures of femur have a bimodal age distribution, with a high incidence in young adults from high energy trauma, such as motor vehicle accidents and a. The omega3 supracondylar plate is indicated for fractures of the distal femur which may include. Supracondylar nailing was initially introduced for the treatment of low femur shaft fractures. Retrograde femoral nailing of periprosthetic fractures around. Five fractures were undisplaced and easily managed. Ebraheims educational animated video describes supracondylar fracture of the distal femur. Reimplantation of an extruded femoral segment after. These fractures invariably present with lot of comminution, many a times with open injuries and bone loss. Fracture, femur, fracture, supracondylar, adult, human fracture fixation, internal fracture fixation, intramedullary search for similar articles you may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.
The most common fractures of adult cats are supracondylar fractures. This is another in the continuing series on radiology in trauma cases from the harborview medical center. Supracondylar soopruhkondehlahr femoral fracture also called distal distuhl femur fracture is when the thigh bone breaks at the knee. Supracondylar definition of supracondylar by the free. The old supracondylar fracture of femur treated by gradual. On presentation, he was alert, with major injuries restricted to his right lower limb. The mechanical lateral distal femoral angle and anatomic posterior distal femoral angle values were within normal range in 80% and 90% of patients, respectively. Open management was used for 32 of the fractures with good to excellent results in 81%, while a good or excellent. Pdf supracondylar fracture of the femur in children. The supracondylar region is the weakest point in the developing elbow and therefore is commonly injured. Fractures of lower end of femur extraarticular or supracondylar in which the fracture does not extend to the knee joint line.
The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Pdf current concepts in fractures of the distal femur. Supracondylar fracture of the femur following total knee arthroplasty tica is rare. Pdf use of a supracondylar nail for treatment of a. Retrograde intramedullary nailing for periprosthetic supracondylar. Pdf surgical management of distalsupracondylar fracture of. Supracondylar fractures are the most common type of upper arm injury in children. The third type is distal femoral fractures, also called supracondylar femur fracture, an injury to the thigh bone just above the knee joint. The knees are the largest weight weightbearing joint in your body. Fracture location is an important consideration in managing supracondylar periprosthetic femur fractures. Treatment of supracondylar fracture of femur with antegrade intramedullary nailing is also challenging. The omega3 supracondylar plate is also indicated for osteotomies of the proximal and the distal femur. Treatment of these fractures is a challenging task for most.
The femur is the largest and strongest bone in the body. Surgical reduction followed by plaster immobilization is required in displaced fracture or just immobilization may be enough for undisplaced fracture. 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. A clinical study of management of supracondylar femur fracture with. Fracture at the lower end of the humerus arm bone and just above the elbow joint is supracondylar humerus fracture. Distal femur fracture an overview sciencedirect topics.
Four of 12 patients had a significant predisposing musculoskeletal condition contributing to the genesis of the fracture. The knee must remain free and mobile at the surgical site. Introduction the effective management of femur fractures present a challenging to the dic the of a 95 cm lag and tube. This study was based on 30 patients of fresh supracondylar fractures of the femur treated with dynamic condylar screw at tertiary trauma center the patients. Current concepts 598 journal of the american academy of orthopaedic. Due to the distal position of the interlocking screws, they were later used for distal femur fractures. In this way, if we wish, we can insert schanz screws into the tibia should this. However, supracondylar fractures in relation to a knee replacement can present a difficult problem, and those occurring around a stemmed prosthesis have a high incidence of problems with union newman, 1987. Supracondylar fracture of femur is common both in elderly with osteoporotic bones and in young patients aft er motor vehicle accidents. Fracture model an oscillating saw was used to create a 2cm gap osteotomy 6. Versafx femoral fixation system surgical technique for. Repair of a severely comminuted distal femur fracture using. From august 1992 to january 1995, 24 patients with 26 supracondylar femoral fractures were treated with a retrograde intramedullary nail. Supracondylar sooprukondilar femoral fracture also called a distal distuhl fracture is when the thigh bone, or femur, is broken at the knee.
Management of type a supracondylar fractures of femur with. Pdf this paper describes current treatment strategies of distal femoral. There are different kinds of breaks, from simple to serious. B, lateral radiograph shows minimal stepoff arrow of anterior cortex of articular surface of lateral femoral condyle. The incidence of periprosthetic supracondylar femur fractures after total knee arthroplasties ranges from 0. Fractures of the distal femur fractures of the distal femur the supracondylar fracture distal femur fractures j. These injuries last threemay be correctly termed fractures of the neck of femur nof. These fractures usually occur in elderly patients with multiple comorbidities and osteoporotic bone. Repair of a severely comminuted distal femur fracture. Mar 31, 2012 this article presents the use of a calcium sulfate bone graft substitute with orif to heal a severely comminuted supracondylar fracture of the distal femur. Distal femur supracondylar fracture everything you need. Surgical treatment of ipsilateral multilevel femoral fracture. In this study of 102 femoral fractures, there was an incidence of 12% of supracondylar fractures.
Sep 18, 2018 a supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. Eleven to 34 months of clinical and radiographic followup evaluation was available in 19 patients. Supracondylar fracture definition of supracondylar. Supracondylar humeral fracture radiology reference. Coupling device and distal femoral replacement for. Supracondylar fracture summary radiology reference. A 42yearold man was admitted in 2008 following a road traffic accident in which he was a motorcyclist hit by a car. Abnormal mechanical axis deviation was observed in 4 20% cases 2 had associated tibia fractures. They are considered serious injuries because of the risk of neurovascular injury or malunion. A, anteroposterior radiograph shows comminuted supracondylar and intercondylar fracture of distal femur with medial displacement and overriding femoral shaft arrows. Jan 02, 2012 supracondylar humeral fractures account for 60 percent of fractures near the elbow among children. Functional outcome of type a and type c supracondylar. Supracondylar fracture of the femur following prosthetic knee arthroplasty.
Pain free, progressive, rehabilitation exercises are essential to restore flexibility and strength to the elbow and upper limb following a supracondylar fracture. A distal portion of the medial condyle should be intact for the lag screw to gain adequate purchase. 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. Ppt supracondylar fractures of the femur powerpoint. Supracondylar fracture fractured humerus physioadvisor. Femoral fracture, intramedullary nailing, total knee arthroplasty, retrograde, periprosthetic. Outcome of supracondylar femur fracture in adults managed. Treatment of supracondylar femoral fractures with a retrogra. Supracondylar fracture pediatric pediatrics orthobullets. Twentythree fractures of the distal femur were treated by open reduction and internal fixation with a compression screw device. Case report a 14year old, otherwise healthy boy presented following a road crash in which he was a motorcyclist hit by a car.
The important factors in the treatment of femoral fractures are appropriate surgical approach, minimal. Under 200 cases in 14 articles have been reported in the english literature, with reported frequency ranging from 0. The incidence of supracondylar fractures above to tal knee. Supracondylar fracture of the femur after a total knee replacement is often a devastating complication. Supracondylar fractures of the femur in the elderly. Partialarticular condylar the fracture extends to the knee joint line but part of the condyles remain attached to the femur shaft. Seventeen, supracondylar femur fractures in 15 severely osteoporotic patients average age, 81. Supracondylar fractures are the commonest fracture at the elbow in pediatric patients. Russell, md, mba university of mississippi disclosures minor stockholder consulting fees institutional grants. Garden city hospital 1998 introduction 47% of all femur. Aug 01, 2012 comminuted supracondylar femur fractures aoota 33a3 are commonly treated with locked plates. A case of severely comminuted femoral supracondylar. Supracondylar fractures of the distal femur brent j.
A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Introduction es account for 7% of all femoral fractures 1. Distal femur supracondylar fracture everything you need to. The effective management of femur fractures present a challenging to the dic the of a 95 cm lag and tube. Supracondylar and intra condylar fractures of the femur are very difficult to manage. Reconstruction of traumatic, open supracondylar femoral. To evaluate the taylor spatial frame tsf for primary and definitive fixation of open supracondylar intracondylar femoral sif fractures. The lower part of the knee joint is the shin bone, or tibia tihbeeuh. Supracondylar nailing for difficult distal femur fractures. Jun 29, 2020 supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. Retrograde femoral nailing of periprosthetic fractures.
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