No loc, helmet on, unable to ambulate 22 severe right knee and thigh pain. Femoral shaft fracture patients will receive intramedullary nailing. Transcondylar fracture definition of transcondylar fracture. Weight bearing is generally restricted for 6 to 12 weeks until radiologic evidence exists of. Femur fracture leads to reduced activity for 107 days, the average. Overview of the femur and pelvis fracture episode of care. 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. The incidence of distal femur fractures among all orthopedic injuries is less than. Distal femur fractures include fractures of the supracondylar and. Please tell us where you read or heard it including the quote, if possible. Transcondylar definition of transcondylar by medical. A fracture in this area can be very painful and make elbow motion difficult or impossible. Infection can occur, requiring antibiotics and further treatment. 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.
Pdf treatment of gustilo grade iii b supracondylar. We help you diagnose your distal femur case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Your hip is a ball and socket joint where your upper leg meets your pelvis. Femoral neck fractures and peritrochanteric fractures are equally prevalent and make up over 90 percent of proximal femur fractures.
Butterfly fragment involves more than 50% of the bone width iv. Overview this condition is a break in the femur at the knee joint. Comparison of supraintercondylar and supracondylar femur. Open reduction of supracondylar fracture of femur without intercondylar extension, with internal fixation. Pdf transcondylar distal humerus fracture with capitulum. These fractures usually occur in elderly patients with multiple comorbidities and osteoporotic bone. Krishnamoorty summary a retrospective study of 34 patients with. Unicondylar fractures of the distal femur sciencedirect. 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. Most distal humerus fractures are caused by some type of highenergy eventsuch as receiving a direct blow to the elbow during a car collision.
A supracondylar femur fracture, also called a distal femur, is an unusual injury that occurs just above the knee joint. Transcondylar distal humerus fracture with capitulum fracture in a pediatric patient article pdf available may 2019 with 97 reads how we measure reads. 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. Supracondylar soopruhkondehlahr femoral fracture also called distal distuhl femur fracture is when the thigh bone breaks at the knee. Displaced transcondylar fracture of unsp humerus, init the 2020 edition of icd10cm s42. 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. Supracondylar fractures are the most common type of upper arm injury in children. As a result, they are typically comminuted or involve osteoporotic bone. But with supracondylar femoral fracture, the muscles in the thigh often contract and pull the bone pieces apart.
Three commonly used implants implants a, b and c are shown in figures a, b and c respectively. 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. 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. May 10, 2008 supracondylar fractures of the humerus are a common pediatric elbow injury that can be associated with neurovascular complications and skeletal deformity. The femur is the largest and strongest bone in the body. Distal femoral fractures pose a difficult problem for the surgeon with significant complication rates and generally unsatisfactory results. Open reduction of transcondylar fracture of femur without intercondylar extension, with internal fixation. Surgical treatment of supracondylar fractures of the femur has become commonplace. Management of distal femur fractures in adults orthopedic clinics. Among the nine patients with low transcondylar fractures, two had nonunion and three died within 3 months of injury. Supracondylar fractures of the femur sciencedirect. Toronto experience with supracondylar fractures from. Answer orif with intramedullary nail of supracondylar. We found in our series of 11 patients that undisplaced fractures have the best.
Femur fracture classification aoota femur diaphysis bone segment 32. Our treatment of these fractures is based upon this classification. Abstract the article is devoted to uptodate diagnostic methods and surgical correction of transcondylar and. Aug 01, 2012 comminuted supracondylar femur fractures aoota 33a3 are commonly treated with locked plates. Complications of surgically treated supracondylar fractures.
Undisplaced fractures are treated with immobilization. Oct, 2017 supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. Supracondylar and intercondylar fractures of the femur. The lateral cortex of the femur has a 10 degree slope, and the medial cortex slopes 25 degrees. Distal femur fractures are the origin of sequelae such as osteitis, stiffness and. 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 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. Supracondylar humeral fracture radiology reference article. Supracondylar femoral fracture central coast orthopedic. Immediate weight bearing of comminuted supracondylar femur. Pelvis fracture patients will receive open reduction with internal fixation, utilizing plates and screws. As depicted in exhibit 1, the patient journey begins when a patient experiences signs and symptoms of a femur or pelvis fracture e. 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.
Pdf current concepts in fractures of the distal femur. In general, casts and braces can hold fractured bones in place as you heal. Examples of indirect reduction methods include manual traction, pointed. Pt landed on a flexed right knee and rolled over to the right side on the ground. Humerus transcondylar and intercondylar fracture youtube. 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. It take a great deal of force to break the thigh bone.
Risks of a fractured femur there are risks and complications with this procedure. Transcondylar fractures of the humerus in children. Nov 19, 2018 condylar and subcondylar fractures constitute 2640% of all mandible fractures see the image below. Right humerus transcondylar upper arm bone fracture. Transposition of the ulnar nerve allows us to use the cubital tunnel as a point for fixation. Links to pubmed are also available for selected references. Femoral shaft fractures orthopaedic trauma association. Ppt distal femur fractures powerpoint presentation. Open reduction of supracondylar fracture of femur with intercondylar extension. Distal femur, fracture, supracondylar and intercondylar fracture, internal fixation, biomechanics. The full text of this article is available in pdf format. Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which require vigilance as imaging findings can be subtle. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. This is done either with manual traction or if neces.
Femur shaft fractures broken thighbone orthoinfo aaos. Supracondylar femur fractures require anatomically stable internal fixation for best results, which usually necessitates surgical treatment. Supracondylar fracture pediatric pediatrics orthobullets. Dec 18, 2017 a supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. The code is valid for the year 2020 for the submission of hipaacovered transactions. 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.
Fourteen fractures were type c3 and 6 were type c2 according. 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. We treated 87 patients with supraintercondylar or supracondylar femur fracture from 2004 to. Treatment tactics of transcondylar and supracondylar. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. Methods eight human cadaver femoral shafts were transected approximately at midshaft after which a tsupracondylar fracture was created via osteotomy. Get a printable copy pdf file of the complete article 2. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. A free powerpoint ppt presentation displayed as a flash slide show on id. There are different kinds of breaks, from simple to serious. 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. Gartlands classification of supracondylar fracture of humerus. Treatment tactics of transcondylar and supracondylar fractures of humerus complicated by peripheral circulation disturbances in children.
A ct scan is obtained which shows intraarticular extension of the fracture, and lateral locked plating with intercondylar lag screw fixation is planned. Our trauma registry was queried for adult distal humeral fractures that were treated surgically between 1996 and 2010. The fracture can range from a small crack to a full break that allows part of the bone to separate. This procedure is the fixation of the thighbone femur using a nail, plate, rod and screws. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. Supracondylar femur fractures orthopaedicsone articles. Republican research centre of emergency medicine rrcem, tashkent, uzbekistan. This condition is a break in the femur at the knee joint. The long, straight part of the femur thighbone is called the femoral shaft. 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. Stabilization of these fractures is difficult because the distal fragments are small and a large portion of their surface is covered with articular cartilage.
In an older person who has weaker bones, however, even a minor fall may be enough to cause a fracture. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Winquist classification of femoral shaft fracture i. Pdf this paper describes current treatment strategies of distal femoral fractures as well. A satisfactory result based on modified mize criteria was achieved in 50 % of supraintercondylar fractures and in 79. We classify transcondylar fractures of the distal humerus into four groups. Open reduction of transcondylar fracture of femur with intercondylar extension, with internal fixation. Understanding the anatomy, radiographic findings, complications, and management options associated with this fracture allow physicians to limit the morbidity associated with this injury. Jan 06, 2017 lcp posterolateral distal humerus plates, with support and lcp medial distal humerus plate duration. The fracture line starts in the lateral or medial intercondylartrochlear groove.
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. Pdf supracondylar fracture of the femur in children. Distal humerus fractures of the elbow orthoinfo aaos. These fractures were surgically treated by ao principles and fixation, and the surgery performed mainly by the two authors. The femoral neck is the most common location for a hip fracture. Fractures of femur, close to or involving condyles, are common and constitute about 30% of total femoral fracturers in dogs alcantara and stead, 1975.
Pediatric supracondylar fractures of the distal humerus. Epidemiology simple supracondylar fractures are typically seen in yo. Lcp posterolateral distal humerus plates, with support and lcp medial distal humerus plate duration. 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. Transcondylar fracture definition of transcondylar. Supracondylar femur fracture adult distal femur trauma options. 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. Open supracondylar fracture of femur short description. Type iv simple sus and intercondylar fractures were the most common in 35. At the top of your femur which is your thigh bone is the femoral head. Use of cbps for supraintercondylar and supracondylar femur fractures treatment led to a high union rate.
Ppt distal femur fractures powerpoint presentation free. Transcondylar medical definition merriamwebster medical. Chapter 53 fractures of the distal femur china quad diaries. Casts and braces may not work well with this type of fracture, unless it is stable and the bone pieces are well aligned. Complications of surgically treated supracondylar fractures of the femur.
Distal femur fractures indirect reduction not for articular surfaces direct visualization and reduction preserves softtissue envelope around metadiaphyseal. Transcondylar definition of transcondylar by medical dictionary. 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. Butterfly fragment is large but there is still 50%of cortical intact between the main fragments iii.