Supracondylar Fracture Of Femur

INTRODUCTION:

Supracondylar region extends from the femoral condyles to the junction of metaphysic with femoral shaft.The distal fragment is displaced and angulated posteriorly due to the pull of gastrocnemius muscle.

MECHANISM:

These fractures are usually due to severe valgus or varus forces with axial loading and rotation due to RTA,fall etc.

PATHO-PHYSIOLOGY:

The distal femur is funnel shaped, and the area where the stronger diaphyseal bone meets the thinner and weaker metaphyseal bone is prone to fracture with direct or indirect trauma.

CLASSIFICATION:

  • Undisplaced fracture
  • Displaced fracture

-Medial displacement

-Lateral displacement

  • Comminuted fractures

CLINICAL FEATURES:

  • Pain
  • Weakness
  • Flexion deformity
  • Inability to use the leg

DIAGNOSIS:

Lab Studies

No specific laboratory studies are necessary

Imaging Studies

Patients with supracondylar femur fractures require anteroposterior (AP) and lateral radiographs of the entire femur to assess associated fractures

and deformity; however, views centered at the knee are also important to assess the specific fracture pattern.

TREATMENT:

It usually consists of:-

-Conservative methods

-Traction methods

-Operative methods

  • Conservative methods:In impacted fractures,a long leg or spica cast is sufficient and in undisplaced fractures ,a long above knee cast after an initial period of skin or skeletal traction.
  • Traction methods:-The choice is mainly skeletal traction and two methods are described:

-Upper tibial traction:The skeletal tractionis applied through the upper end of

tibia.Initial weight used is around 15 to 20 lbs and is subsequently reduced.

The traction is given for 8 to 12 weeks and the patient is put on cast braces.

-Two pin traction method:-Traction is added through the distal femur apart from the traction given through the upper end of tibia

  • Operative methods:-This consists of open reduction internal fixation.

The choice is between medullary fixation and blade plate fixation.

CONTRAINDICATIONS:

Patients in whom surgery is contraindicated include patients who are bedridden or nonambulatory with nondisplaced or minimally displaced fractures in which a brace may provide acceptable stability and alignment is not an issue. (Displaced unstable fractures in this group still may require surgery to improve nursing care, decrease pain, and prevent further soft tissue damage by mobile bone fragments.) Patients with severe life-threatening or other medical problems in which the risks of anesthesia are high may also be treated nonoperatively.

COMPLICATIONS:

  • Delayed union
  • Malunion
  • Non-union
  • Injury to the popliteal vessels and common peroneal nerves
  • Knee stiffness
  • Deep vein thrombosis
  • Infection

 

PHYSIOLINE’S SPECIALISED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Relief pain
  • Restoring range of motion
  • Strengthening of muscles
  • Prevention of complications
  • Gait training
  • Restoration of activities of daily living

 

Visit Physioline for the Consultation and treatment