Proximal femur fracture and vascular injury in adultscase report. Jul 28, 2006 however, due to the undisplaced oblique diaphyseal right femoral fracture, management of that femur was revised to open reduction, cerclage wiring of the distal femoral fragment, and fracture fixation with a 12hole 95degree dynamic condylar screw over the cerclage wires below. This type of cornoal fractures of he distal femur are further classified into. The femur, or thigh bone, is the largest and strongest bone in the human body. Distal femur thighbone fractures of the knee orthoinfo. Early femur fracture fixation is associated with a reduction in pulmonary complications and hospital charges.
The femur has a rich vascular supply, and most recent reports describe union rates between 90% and 99% when treatment with an antegrade locked intramedullary nail is performed. Drugs that treat osteoporosis also can cause small risk of thigh bone fractures. The anatomy of the distal femur explains the three major types of fracture. A fracture that occurs at the distal end of the femur bone, which includes the femoral condyles and the metaphysis. A femoral fracture is a bone fracture that involves the femur. Current understanding of epidemiology, pathophysiology, and management of atypical femur fractures. How much would my femur stretch on the moon, ie what is the elasticity of the femur, and is it true it can support presures of one ton. Oct 10, 2018 a thorough history is imperative for all femur fractures, but particularly for fractures that occur with overuse or minimal trauma. Fractures of the thighbone that occur just above the knee joint are called distal femur fractures. The study data consisted of patients who were admitted for an acute episode of care at a queensland hospital offering orthopaedic services, were aged 60 years or more, and had at least one diagnosis indicating fracture of the proximal femur on admission to hospital.
Nail will not have an isthmic fit may need blocking pinsdrill bitsscrews percutaneous or open clamps nail will lock a fracture in a malreduced position as easily as it will. Two to six percent of femoral shaft fractures also have femoral neck fractures. Fractures of the distal part of the femoral bone are a result of direct trauma. Children that sustain femur fractures prior to walking age should be screened for nonaccidental trauma. The femur is an important bone in the upper leg of the human body. Two of 12 patient matches differed in the presence of diabetes. Because of the anatomy of the distal femur, only surgical treatment is indicated to stabilize the fracture. Eightyfive per cent of the coronal plane fractures involved the lateral condyle and 9% incorporated both condyles. Jul 16, 2014 in children under 4 years the possibility of physical abuse must be kept in mind. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone.
Distal femur, fracture, supracondylar and intercondylar fracture, internal fixation, biomechanics. Retrograde im nail minimally invasive good option for distal fracture with concomitant proximal femur fracture that will be treated with a separate device must maintain the reduction throughout procedure. Regarding the epidemiology, two pikes characterize these fractures, also differentiated by age, traumatic energy and, thus, fracture aspect. At latest followup, 9 month after the injury, uneventful healing of the femur fracture had occurred.
Fracture patterns are clues to the type of force that produced the break. Femoral shaft fractures in emergency medicine clinical. In children under 4 years the possibility of physical abuse must be kept in mind. The full text of this article is available in pdf format. The distal femur is where the bone flares out like an upsidedown funnel. Pdf mortality after distal femur fractures in elderly patients. Many times, people who have broken a bone have suffered a single fracture. This is the group for fractures of femur with mcc diseases in version msdrg v37. Fractures of the distal femur the supracondylar fracture distal femur fractures j.
In many cases, disability is secondary to injuries to other body systems. The femur, also known as the thigh bone, is the longest bone in the body. Jul 10, 2015 morbidity and mortality of bilateral femur fractures. The most common mechanism is an indirect trauma on a bent knee, and more rarely direct trauma by crushing. Distal femur fracture fracture of distal end of femur. Sometimes these fractures extend into the knee joint and separate the surface of the bone into a few or many parts. In this study, plain radiographs alone did not identify 31% of. The initial evaluation of a trauma patient with a femur fracture should include radiographs of the chest, ap pelvis, hip, and knee. A femoral neck fracture, also called an intracapsular fracture, occurs at the level of the neck and the head of the femur, and is generally within the capsule. Read more about fracture symptoms, treatments and more here. The required details of the history will vary based upon the category of fracture i. Your digital gateway to expertise, education, and innovation. Distal femur lecture orthopaedic trauma association.
Distal femur thighbone fractures of the knee a fracture is a broken bone. Due to trapezoidal shape of the distal femur erroneous plate placement can cause malreduction. Chapter 53 fractures of the distal femur china quad diaries. Treatment options for distal femoral fractures ncbi. A fracture should be suspected if one or more of the following are present. May 04, 2016 the b3 type fracture popularly known as hoffas fracture has immense clinical signifcance in the outcome following treatment and has been further subdivided into three types 3,8,10. The femur is indeed one of the strongest bones in the body, and a fracture of the shaft of the femur usually occurs only after a car accident or ski accident or some other major trauma. Treatment options for femoral shaft fractures by age. Morbidity and mortality of bilateral femur fractures. Ppt fractures of the distal femur powerpoint presentation. A hip fracture means a fracture of the proximal femur proximal to 5 cm below the lesser trochanter.
Unreamed antegrade unreamed nailing was performed with protection of the proximal fragment with cerclage wires. These injuries make up about 37 % of all femur fractures courtbrown and caesar 2006. Hip fractures are the most common reason for admission to an orthopaedic trauma ward. Intramedullary nailing for femur fracture management. Nov 29, 2011 the femur is indeed one of the strongest bones in the body, and a fracture of the shaft of the femur usually occurs only after a car accident or ski accident or some other major trauma. Fractures of the distal femur, even those with articular extension, are well suited to surgical fixation with modern precontoured anatomic plates and nails. Find out if you know the symptoms and available treatment options for a femur. Between 1980 and 1989, reports on 2,165 fractures of the distal part of the femur 1,051 women and 1,114 men were collected by ao documentation and are analyzed in the present paper.
Garden city hospital 1998 introduction 47% of all femur. A femoral fracture is a fracture of the femur thigh bone. Age, fracture pattern, fracture location, softtissue trauma and presence of associated injuries all influence the treatment modality table 1. They are severe injuries caused by great violence and velocity. A fracture of the distal femur is a break or crack that occurs anywhere within the lower region of the femur near the knee fractures of the distal femur are usually caused by direct injuriestrauma to the leg, associated with falls. Risk of atypical femoral fracture during and after. Management of distal femur fractures with modern plates and. Intracapsular fractures involve the femoral neck between the edge of the femoral head and insertion of the capsule of the hip joint. The treatment of distal femur fracture is one of the most important. A free powerpoint ppt presentation displayed as a flash slide show on id. Risks of a fractured femur there are risks and complications with this procedure. Distal femur thighbone fractures of the knee orthoinfo aaos. This is considered to be the terminal 1015 cm of the distal femur.
Aug 12, 2015 distal femur fractures involve the distal one third of the femur, consisting of the region between the diaphysealmetaphyseal junction and the articular surface of the femoral condyles. Fractures of the distal femur occur in a bimodal age distribution. Management of distal femur fractures in adults orthopedic clinics. A thorough history is imperative for all femur fractures, but particularly for fractures that occur with overuse or minimal trauma. If any concern for a femoral neck or acetabular fracture exists, a ct should be performed to rule these out. Download pdf bmc musculoskeletal disorders biomed central. Supracondylar femur fracture adult distal femur trauma options.
This could be a hairline fracture, a complete break, or something in between. A femur fracture is typically sustained from highenergy impact such as motor vehicle collisions, falls from playground equipment, falls from furniture or resulting from a twisting mechanism. Stabilization of distal femur fractures with intramedullary nails and locking plates eleven of 12 patients were exact matches based on open versus closed fracture. Drugs that treat osteoporosis also can cause small risk of. Distal femur fractures in adults orthopaedics and trauma. A femur fracture is a crack in the femur or thigh bone, which is considered as one of the strongest bones in the body. The system allows for polyaxial screw placement with subsequent screw. These injuries must be differentiated from insufficiency fractures, which, though similar in. A spiral fracture is usually caused by a fall in which the foot is anchored while a twisting force is transmitted to the femur. There are multiple alternatives for the definitive tre. Distal femoral fractures occur predominantly in two patient populations.
A recent study reported coronal plane fracture in 38. However, due to the undisplaced oblique diaphyseal right femoral fracture, management of that femur was revised to open reduction, cerclage wiring of the distal femoral fragment, and fracture fixation with a 12hole 95degree dynamic condylar screw over the cerclage wires below. By continuing to browse this site you are agreeing to our use of cookies. Treatment of distal femur fractures remains clinically challenging.
This procedure is the fixation of the thighbone femur using a nail, plate, rod and screws. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. Distal femur fractures involve the distal one third of the femur, consisting of the region between the diaphysealmetaphyseal junction and the articular surface of the femoral condyles. I have removed this objectionable description of the femur. Numerous adjuvant techniques are available to the treating surgeon to obtain and maintain reduction while preserving fracture biology. With intercondylar split fracture patterns, the two heads may also cause the distal condylar fragments to separate and rotate. Introduction the femur is the longest bone of the body which, by itself, forms the skeleton of the thigh. Distal femur fractures orthopaedic trauma association.
Do you want to use the redesigned ao sr like an app. Distal femur fractures orthopaedic trauma association ota. The incidence of distal femur fractures among all orthopedic injuries is less than. Pain swelling bruising loss of function deformity bony crepitus where communication is difficult e. Femoral shaft fractures orthopaedic trauma association. Q subsequent encounter for open fracture type i or ii with malunion r subsequent encounter for open fracture type iiia, iiib, or iiic with malunion s sequela distal femur fracture icd9 821. The bone can break straight across transverse fracture or into many pieces comminuted fracture. The capsule is the softtissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.
Mortality after distal femur fractures in elderly patients article pdf available in clinical orthopaedics and related research 4694. This lesson is about fracture of the femur and related symptoms, treatment. Distal femur indicates the part of the thigh bone just above the knee. Infection can occur, requiring antibiotics and further treatment. Fractured neck of femur pathway hillingdon hospitals nhs. Left a transverse fracture across the distal femur center an intraarticular fracture that extends into the knee joint right a comminuted fracture that extends into the knee joint and upwards into the femoral shaft. Distally, the lateral and medial condyles articulate with the tibial plateau of the tibia forming the. Labronici pj, santos filho fcd, diamantino ylo, loureiro e, ezequiel mcdg, alves sd. A femoral shaft fracture is defined as a fracture of the diaphysis occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle occurs by chronic, repetitive activity that is common to runners and military. Pdf current concepts in fractures of the distal femur. Femur injuries and fractures clinical presentation. In more complex fractures, ct is used to delineate intraarticular extension, degree of comminution, and fracture lines in the coronal plane. Distal femur fractures most often occur either in older people whose bones are weak, or in younger people who have high energy injuries, such as from a car crash.
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