femoral supracondylar fracture
Introduction
Introduction to supracondylar fracture of the femur The supracondylar fracture of the femur is a fracture within 5 cm of the internal and external femoral condyles. It should not include internal and external ankle fractures and intercondylar fractures (AO distal femoral fractures). The supracondylar fracture is usually an extracapsular fracture of the joint, while the ankle fracture (B-type fracture of the distal femur) and the intercondylar fracture are intracapsular fractures, but the supracondylar fracture and the intercondylar fracture often overlap each other. Supracondylar fracture or C-type fracture of the distal femur. basic knowledge The proportion of illness: 0.02% Susceptible people: good for children Mode of infection: non-infectious Complications: radial artery injury
Cause
Causes of supracondylar fracture of the femur
(1) Causes of the disease
Both direct violence and indirect violence can cause injury.
(two) pathogenesis
The supracondylar fracture of the femur is divided into extension type and flexion type, which is caused by direct violence or indirect violence. The extension fracture is caused by the knee joint extension injury. The fracture line is from the front to the back. When the flexion position is injured, it can be formed. Lateral up-and-down oblique fractures, horizontal or comminuted fractures can also occur under direct violence. At present, high-energy injuries caused by traffic accidents and industrial and agricultural trauma are common, often comminuted supracondylar fractures or warts. Intermittent fracture.
Prevention
Prevention of supracondylar fracture of the femur
Prevention work starts from the usual time. The disease is mainly caused by traumatic factors, so it is necessary to pay attention to safety.
Complication
Complications of supracondylar fracture of the femur Complications, radial artery injury
1. Stretch fractures can often cause damage to the brachial artery after femoral condyle.
2. Causes of femoral condyle fracture not connected:
1 is not fixed correctly or not strong;
2 unreasonable functional exercise of the affected limb;
3 excessive traction;
4 infection;
5 There is soft tissue embedding between the broken ends of the bone. Once it occurs, it can be removed surgically, using strong internal fixation and bone transplantation.
3. Femoral condyle fracture malunion:
Malformation of the femoral condyle fracture is often accompanied by an articular surface skew of the femoral condyle.
the reason:
1 The fracture end of the fracture was poorly restored, and the anatomical reduction or internal fixation was not achieved. The fixation was not strong and the fracture end was re-displaced.
After the fracture of the two femoral condyles, due to the compression of the cancellous bone, there is often a bone defect after the reduction, and the side is collapsed when the bone graft is not actually performed during the operation.
3 inappropriate weight bearing, the fracture end healed in non-functional position, malunion of the femoral condyle can cause external rotation of the knee joint, flexion and valgus deformity; malunion of the femoral condyle can cause internal rotation of the knee joint, buckling and Inverted deformity.
4. The internal fixation is not loose:
Causes: Intercondylar fractures of the femur are often multi-directional, and severe comminuted fractures account for more than 1/2. This brings many difficulties to internal fixation and functional exercise, and internal fixation often has loosening. The reasons are:
1 severely comminuted fracture of the asbone;
2 improper selection and use of internal fixation, such as the lag screw used in the operation does not play a compression between the bone;
3 External fixation and unreasonable early functional exercise were not used after operation.
Symptom
Symptoms of supracondylar fracture of the femur Common symptoms Ischemic joint deformity below the calf
1. Systemic symptoms: Most of the fractures of the femoral shaft are light, and the incidence of shock is 1/8 to 1/10 of the femoral shaft fracture.
2. Local symptoms:
(1) General symptoms of fracture: mainly manifested as swelling of the fracture, pain and annular tenderness and conduction pain in the upper part of the femoral condyle.
(2) Displacement: manifested as lateral displacement of the distal end of the fracture and knee flexion deformity.
(3) dysfunction: mainly manifested as affected limbs, especially knee dysfunction.
(4) attention to complications: mainly whether there is injury and the performance of radial artery or other vascular injury.
Examine
Examination of supracondylar fracture of the femur
X-ray examination can show fractures and types, involving neurovascular injury, feasible MRI or angiography.
Diagnosis
Diagnosis and diagnosis of supracondylar fracture of femur
History of trauma
Generally, it is caused by more intense violence.
2. Clinical features
In addition to local pain, swelling and tenderness, and malformation dysfunction, special attention should be paid to the presence or absence of pulsation and strength of the dorsal artery, and contrast with the healthy side, while paying attention to the activity and sensation of the toe to determine the blood vessels and nerves of the ankle. Have you been involved?
3. Imaging examination
Conventional X-ray plain film can clearly diagnose and clearly show the type and displacement of the fracture; soft tissue injury, especially those involving neurovascular injury, can be supplemented by MRI or angiography.
This disease is generally not confused with other diseases.
