Surgical Treatment of Supracondylar Femoral Fractures
Journal Title: International Journal of Contemporary Medical Research - Year 2016, Vol 3, Issue 1
Abstract
Introduction: In today’s fast paced world high energy trauma is common. Supracondylar femur fractures are one of the common fractures encountered. The distal femur has wide medullary canal, thin cortex and often associated with comminution. Management of these supracondylar femoral fractures is a challenge to orthopaedic surgeons. Still there is controversy in the correct line of management to be selected. The surgeons will face difficulties in restoring the anatomical alignment and joint congruity. Materials and methods: Between Jan 2009 to Jun 2014, 26 distal femoral fractures treated with supracondylar nail. 2 pts lost for follow-up. Of the remaining 24 fractures, 19 were closed fractures 5 were of open fractures. Average age was 54 yrs (20 to 84 yrs). 60 % of pts were older than 50 yrs of age. AO classification was used for these fractures (A type: 14, C type: 10). Open nailing was done in 6 cases (4 for nonunion, 2 for failed DCS). Bone grafting was done in 4 patients. Results: Average follow-up was 14 months (6 - 24 months). Wt bearing was allowed depends on the progression of union radiologically and clinically. Functional assessment was done using a scale developed by Sanders et al for distal femoral fractures. 23 fractures healed well and 1 pt had nonunion. Average healing time was 16 to 18 weeks. 1 pt had malunion, 1 pt had infection at the fracture site, which went on for good union (grade IIIb compound). Knee stiffness was found in 4 cases (<60 degrees). Conclusion: Supracondylar nail provides stable fixation in a region of femur where a widening canal, thin cortices, and poor bone stock make fixation difficult. The retrograde supracondylar nail is an excellent alternative to lateral fixation devices for supracondylar fractures of femur.
Authors and Affiliations
P. Ramesh Vyravan, M. Mohankumar
Keywords
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