27. Supracondylar fracture of the femur

Essay 27- Supracondylar fracture of the femur

Definition

• Fracture in which the fracture line is situated immediately above the condyles of the femoral bone (extra-articularly)

Etiology (mechanisms)

• Indirect flexion
• For example after a fall with flexed knee as a result of which an oblique fracture occurs
• Torsion (screwlike fracture line)
• Scissor-like or compression
• Direct trauma (crushed fracture)

Classification

• Bifragmentary
• With a 3rd fragment
• Crushed
• Dislocation of the fragments is typical for the supracondylar fractures!

Symptoms

• Angular distortion with an angle open ventrally and laterally
• The anterioposterior diameter of the thigh is increased and there is a certain shortening
• Pathological mobility
• Bone crepitations
• Hemorrhage and swelling of soft tissue

First aid

• Knee must be flexed under a right angle
• In flexion, knee is pulled along its longitudinal axis!
• Immobilization of the extremity is done in a flexed knee
• A plaster splint is placed dorsally starting from the gluteal fold and reaching the toes

Treatment

• Extension with a Kirschner's needle through the tibial tuberosity
• Extremity is placed on a Brown's splint, flexed, but in such a way that the angle curve is positioned above the fracture and not above the knee
• Extension lasts 4-5 weeks and control X-rays are regularly made!
• After the fracture healing and the removal of the plaster, continuous rehabilitation is conducted
• Surgical- open repositioning and metal osteosynthesis with G-shaped plaque and screws