17. Supracondylar femoral fractures
- Direct screws to avoid joint
- Too long out medial
- AP x-ray—screws end
1 cm short of projected
medial cortex
Distal femoral geometry
22. Supracondylar femoral fractures
ORIF (open reduction and internal fixation) technique
DCS/blade plate
Summation wire technique:
- A K-wire along joint line
- B K-wire along anterior condyle
- C Summation K-wire parallel to A and B
36. Supracondylar femoral fractures
First steps
- Reduce articular surface
- Lag screws
- Must place screws where they won’t interfere with your other fixation
39. Supracondylar femoral fractures
Retrograde intramedullary nail
- Extraarticular fractures
- Hard to get anatomic
alignment
- May ―blow out‖ unrecognized
intercondylar fractures
43. Supracondylar femoral fractures
Complications
- Malalignment—technical problems
- Recurvatum—due to gastrocnemius pull
- Loss of reduction—poor implant choice
- Varus—nonlocking buttress plate
- Failure of fixation—osteoporosis
- Nonunion
- Knee stiffness
44. Supracondylar femoral fractures
Pitfall to avoid complication
–Understand the anatomy
–Well visualized the fracture pattern
(CT scan)
–Choose your Suitable implant
–Well plan operation
–Prepare the unexpected