lower2

OBJECTIVES
• Fracture femur • Fracture lower femur( supracondylar fracture) • Fracture patella • Knee dislocation • Q tendon rupture • Patellar tendon rupture
DISTAL FEMUR FRACTURES
• Femur fracture from 5 cm above the distal metaphyseal flare to the distal articular surface
• Bimodal distribution • – Young: high-energy injury, typically more displaced • – Elderly: low-energy injury, typically less displaced
• Increased risk for vascular injury with increased fracture displacement
IMAGING
• • AP and lateral knee x-rays. • • Traction views may be helpful to further delineate fracture pattern in some cases. • • CT scan: concern for intraarticular extension
TREATMENT
• Nonoperative • – Non-weight bearing, early knee range of motion with hinged knee brace. • – Consider in nondisplaced fractures, nonambulatory patients, and patients with excessively high perioperative mortality risk.
PRINCIPLES OF SURGICAL FIXATION
• • Indicated in displaced fractures • • Anatomic reduction of articular surface (when involved), restoration of length, alignment, and rotation