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Faculty of Medicine

Faculty of Medicine. Chiangmai University. SUPRACONDYLAR FEMORAL FRACTURE. THEERACHAI APIVATTHAKAKUL. 17 March 2011. Supracondylar Fractures. “ zone between femoral condyle. and junction of metaphysis. ~9cm.from articular surface”. DEFORMING MUSCLE. QUADRICEPS. HAMSTRINGS.

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Faculty of Medicine

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  1. Faculty of Medicine Chiangmai University

  2. SUPRACONDYLAR FEMORAL FRACTURE THEERACHAI APIVATTHAKAKUL 17 March 2011

  3. Supracondylar Fractures “ zone between femoral condyle and junction of metaphysis ~9cm.from articular surface”

  4. DEFORMING MUSCLE QUADRICEPS HAMSTRINGS GASTROCNEMIUS

  5. Stewart MJ etal. JBJS 1966;48A “Additional trauma of surgery and the proximity of metallic implants to the joint predispose toexcessivereactionand subsequentadhesion lead to joint stiffness”

  6. Schatzkeretal.INJURY 1974;6 SchatzkerandLambertCORR 1979 • 71-75% good to excellent result • Accurate anatomical reduction • Stable internal fixation • Early mobilization

  7. ANATOMY • Surgical anatomy • Mechanical axis • Anatomical axis

  8. LATERAL VIEW • Anterior half Blade position • Posterior half

  9. CROSS SECTION • Trapezoid shape • Width anterior > posterior • Medial ,lateral wall inclination

  10. ANATOMY LATERAL VIEW CROSS SECTION

  11. Classification • severity of injury • treatment • prognosis

  12. AO CLASSIFICATION

  13. CONSERVATIVE TREATMENT • Difficult articular reduction • Posterior displacement • Joint stiffness • Muscle atrophy

  14. CONSERVATIVE TREATMENT SINGLE- PIN DOUBLE-PIN

  15. OPERATIVE TREATMENT

  16. INDICATION FOR ORIF • Displaced intra-artricular Fx. • Multipleinjuries,ipsilateralinjuries • Mostopenfractures • Associatedvascularinjuries • Pathologicalfracture • Irreducible fracture • unreduciblefracture

  17. CONTRA-INDICATION • Active infection • Severely contaminated open Fx. • Severe osteopenia • Inadequate facilities • Inexperienced surgeons

  18. LATERAL APPROACH TIBIAL TUBERCLE OSTEOTOMY

  19. Tibial tubercle osteotomy • Complete articular exposure • Pre-drill tibial tubercle • Fix to posterior cortex

  20. Tibial tubercle osteotomy

  21. CONDYLAR BUTRESS PLATE

  22. THANK YOU Faculty of Medicine Chiangmai University

  23. SUPRACONDYLAR FEMORAL FRACTURE THEERACHAI APIVATTHAKAKUL AO BASIC COURSE 24-26 AUG,1998

  24. What is your purpose for presentation in your practice? • Lectures • Podium presentation

  25. Davos 2006

  26. Davos 2008

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