Rf. Ostrum et C. Geel, INDIRECT REDUCTION AND INTERNAL-FIXATION OF SUPRACONDYLAR FEMUR FRACTURES WITHOUT BONE-GRAFT, Journal of orthopaedic trauma, 9(4), 1995, pp. 278-284
Thirty supracondylar-intercondylar fractures of the distal femur were
treated in a prospective series using an indirect reduction technique.
From January 1988 to July 1993, patients who entered into this protoc
ol had undergone fixation with a distal lateral plate without strippin
g of the medial soft tissues and without bone graft. With this techniq
ue, 86.6% excellent and satisfactory results were achieved using the N
eer rating system. Of the three failures, two were in elderly, osteopo
rotic women with comminuted intraarticular fractures, and one failure
occurred in a renal transplant patient with bilateral quadriceps ruptu
res despite a good result from her femur fracture. Only one patient wi
th a grade 2 open fracture and comminution developed a nonunion, which
eventually healed after bone grafting. The results of this technique
compare favorably with other series of osteosynthesis of supracondylar
femur fractures in the orthopaedic literature without the added morbi
dity associated with autogenous bone grafting. The surgical technique
is demanding and may not be suitable for patients with severe open fra
ctures with devascularized bony fragments or marked osteoporosis.