In this randomized prospective study, 42 patients with extraarticular distal femur fractures were segregated into two groups. Management of fractures of distal femur journal of. As you know, if it is not in the report, it was not done. Out of the 21 patients 21 cases who underwent separate vertical wiring12 for extraarticular fracture of the distal pole of the patella at our institution between march 2005 and march 2010, 18 patients with a minimum 1year followup were included in this study. An intraarticular fracture is a fracture that crosses a joint surface. These fractures can damage the articular cartilage and subchondral bone and lead to articular incongruity, stepoff and instability. Instruments and implants approved by the ao foundation.
The comparability of studies of extraarticular proximal femur fractures is compromised by the lack of a widely accepted, simple classification system with clinical and prognostic relevance. Below is an xray of a severely comminuted fracture of the distal phalanx of an adult foot. The full text of this article is available in pdf format. Distal femur fractures orthopaedic trauma association ota. The aim of this study is the evaluation of complication rates of different types of proximal extraarticular femur fractures, and a definition of three different fracture types based on the distinguishing fracture characteristics, with clinical, therapeutic and prognostic relevance. Treatment considerations include restoring joint surface congruity and. In case of an intraarticular fracture, open reduction and internal plate fixation should be performed with. Extra articular distal femoral fractures in the elderly treated with.
Early administration of antibiotics with a thorough debridement and irrigation is of utmost importance. The location of the cora determines surgical treatment because. Minimallyinvasive fixation of distal extraarticular. Request pdf management of distal femoral fractures extra articular extraarticular distal femur fractures are challenging orthopedic injuries that occur less commonly than proximal and. Extraarticular distal femur fractures are challenging orthopedic injuries that occur less commonly than proximal and diaphyseal femur fractures. The personality of fracture, associated soft tissue damage, neurovascular status and functional demands of patient can. In this randomized prospective study, 42 patients with extraarticular distal femur fractures were segregated into two groups based on internal fixation with distal femoral locking plate n22 and retrograde nail n20.
Outcome of retrograde interlocking intramedullary nailing. Imn was probably preferential to plating for dtf given its higher functional score p 0. The skin incision starts at gerdys tubercle and goes on in a proximal direction to expose the fracture zone. Download full thesis topics for ms dnb orthopaedics degree. This publication is not intended for distribution in the usa. The indications for retrograde nailing are classic. Recent advances in intramedullary nail design and plateandscrew fixation systems have further increased the options for management of these fractures. Compared to extraarticular fractures, intraarticular have a higher risk for developing longterm complications, such as posttraumatic osteoarthritis. Conditions fracture and orthopaedic clinic limited.
The doctor must dictate this to show up in the body of the report. Extraarticular fractures include intercondylar fractures, supracondylar fractures, epicondylar fractures, and condyle fractures. Fractures to joints are more complicated to treat and heal than simple fractures, as multiple bones are involved. The anatomically shaped and angular stable fixation system for extraarticular fractures of the distal humerus. The thin soft tissue coverage on the anterior aspect of the distal end of the femur is a frequent problem. The aoota fracture classification system is the most universally used4 figure 1. Minimallyinvasive internal fixation of extraarticular. However, plating had a lower malunion rate than imn p for extraarticular fractures. Evaluation of complications of three different types of.
Fractures of the elbow include extraarticular and intraarticular fractures. Most frequently, 33 a1 n 4 and 33 a2 n 7 fractures types were encountered in the distal femur, no 33 b and 33 c were included while type 32 a1 was predominantly seen. Radiological assessment showed statistically better results at. Modelling and optimization of physical systems 8, pp. Extra articular supracondylar femur fractures managed with locked distal femoral plate or supracondylar nailing. Supracondylar extraarticular fractures of humerus are difficult to treat and are fraught with complications. Download full thesis topics for ms dnb orthopaedics degree orthodnb. Fracture of the distal femur may be broadly classified as extraarticular, intraarticular unicondylar, or intraarticular bicondylar, with subclassifications for specific patterns and degrees of comminution. We selected particular cases of extraarticular causes of hip pain from our institution database between october 2007 and november of 2012. Management of extraarticular fractures of the distal.
An intraarticular fracture is a bone fracture in which the break crosses into the surface of a joint. According to the aoasif, fracture classification 812 40% belonged to type 33 distal femur and 1220 60% to type32 femoral shaft. Metaanalysis of postoperative complications in distal femoral. As implant design and technology improve, the rate of fracture healing and complication rate have both improved. Pdf extra articular supracondylar femur fractures managed with. Extra articular supracondylar femur fractures managed with. All of these factors are believed to play a role in the overall outcome of these fractures and may vary in their individual importance among different joints. Management of extraarticular distal tibial fractures with combined external fixation and limited internal fixation. Fracture of femur in adults a hospital based prospective study 284.
Intramedullary nailing versus plating for extraarticular. Temporizing with external fixation may be necessary. Surgical technique this publication is not intended for distribution in the usa. Injury patterns for children and adults are quite different. Pdf current concepts in fractures of the distal femur. The orthodox management of distal third femur fractures described by watson jones and john in the form of casts and braces. Differences in softtissue health and construct stability must be considered when choosing between intramedullary nailing and plating of the distal tibia. While intraarticular fractures appear very similar to those that do not involve a joint space extraarticular fractures, intraarticular fractures are significantly more serious because they are associated with a much greater incidence of longterm.
Intraarticular fractures may cause joint stiffness and arthritis because the joint surface becomes affected. Your digital gateway to expertise, education, and innovation. Nail will not have an isthmic fit may need blocking pinsdrill bitsscrews percutaneous or open clamps nail will lock a fracture. Ipsilateral proximal femur, tibia or ankle open injuries occur in 510%. Fixation of distal extraarticular femur fractures with locking plates 679 that concentrated the loads at the most proximal open hole. Supracondylar femur fracture treated with external fixation and minimal internal fixation. The aim of the study is to define the complication profile as well as differences relating to age, gender and survival rate of simple trochanteric fractures. Management of extraarticular deformity in the setting of. Usually associated with high energy mechanism associated fractures. None of the patients had a combined fracture on the ipsilateral side.
Bone fragments inside the damaged joint may impede healing time and efficacy. Management of distal femoral fractures extraarticular. Distal femur fractures orthopaedic trauma association. This technique allows immediate restoration of length and alignment with minimal surgical exposure, but it often cannot hold the alignment in the long term and has associated problems with pin care. The anatomically shaped and angular stable fixation system for extra articular fractures of the distal humerus. With extraarticular deformity preoperative planning for tka in cases of extraarticular deformity in the femur, tibia, or both should include1themagnitudeindegrees of the extraarticular deformity and 2 the location of the deformity cora in relation to the knee joint. Not only intraarticular, extraarticular but also it must mention the 2 or 3 and more fragments for the intraarticular. The chief reason for the infrequent use of this type of operation is that most patients with ununited fracture of the neck of the femur are seen by the surgeon when the femoral neck is practically absorbed. Intra and extracapsular fractures greenspan 1992 727p. Below is an xray image of an extraarticular fracture of the proximal phalanx of the hallux great toe of a child. Intraarticular fractures are simply fractures that involve a joint space see below figure.
Elbow fractures are commonly encountered in the acute care setting. Femur in most total knee arthroplasties tkas for arthritic knees with intraarticular varus or valgus deformity, both alignment and. The effectiveness will be assessed in two different areas. Extraarticular a partial articular b complete articular c. Pdf comparison of retrograde intramedullary nailing and. Fourteen of 6620 studies with 842 patients were included. Christopher haydel, md department of orthopaedic surgery and. Orif is recommended as ideal treatment option for extraarticular fracture distal end humerus. Neurovascular injuries are mostly observed in the type 3 distal femur complex trauma. Pdf this paper describes current treatment strategies of distal femoral fractures as. The muscles are left attached to the fracture fragments for optimal blood supply. Pediatric coalition fracture of the dipj fifth toe initial and healed. Muller classification of extraarticular extension greenspan 1992 558ap.
688 46 307 1228 398 686 1000 1488 365 276 708 1401 42 128 1175 879 48 794 1049 1481 500 1524 333 1455 479 377 1032 1177 1247 778 411 235 1420 889 912 1420 1106 269 1081 512 968