A Clinical Study on the Supracondylar Fractures of the Femur

Shin, Kyoo Ho; Han, Dae Yong; Park, Byung Moon

Abstract

The management of supracondylar fractures of the femur remains controversial. Most studies over the past twenty years have attempted to compare the results of non-surgical with those of surgical methods. Until a few years ago, conservative treatment was considered superior to internal fixation of supracondylar fractures of the femur. However, the development of new fixation devices and techniques have, according to several investigations, improved the results of the treatment of these fractures. The following clinical results were shown by analysis of 96 cases of supracondylar fractures of the femur treated in the Department of Orthopedic Surgery, Yonsei University, College of Medicine during the past 10 years from Jan. 1971 to Dec. 1980. 1. The prevalent age distribution was between 21 and 50 years of age (79.1%), and the ratio between males and females was 3.4:1. The most common cause of injury was car accidents (51.0%). 2. A classification of supracondylar fractures was unicondylar, simple supracondylar and intercondylar. Intercondylar which was subdivided into Type I, II-A, II-B, III according to Neer's classification. 3. Fifty nine patients (61.4%) were associated with injuries of other parts and the most frequent associated fracture was tibial fracture and the most common associated soft tissue injury was cerebral concussion or contusion. 4. The methods of treatment: conservative management by using skeletal traction for 34 cases, surgical treatment by open reduction and internal fixation for 58 cases and A-K amputation for 4 cases due to populiteral artery injury. 5. Fifty nine cases were suitable for result analysis. The satisfactory result of surgical treatment was 63.4% and conservative treatment was 50.0% respectively. The factors affecting the final results were Type of fracture, severity of injury, and rigid internal fixation. 6. The main complications of the supracondylar fractures of the femur were delayed union (10.2%), infection (10.2%), and traumatic arthritis (13.3%). 7. Finally, the results of treatment depend largely on anatomical reduction, rigid fixation, early joint motion.