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Supracondylar Fractures of the Femur - An Overview

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Supracondylar fractures of the femur are complicated fractures of the thigh bone. Read this article to learn more about this condition and its treatment.

Written by

Dr. Asna Fatma

Medically reviewed by

Dr. Anuj Gupta

Published At December 22, 2022
Reviewed AtAugust 29, 2023

What Is a Fracture?

A fracture is defined as a breach or break in the continuity of the bone. A bone fracture can be complete or partial. Any bone in the body is susceptible to fractures. Several different mechanisms can cause a bone to fracture. Fractures frequently result from slips, accidents, or sports trauma. Some of the common symptoms of a bone fracture include; excruciating pain, deformity of the bone, swelling or inflammation in the affected area, bruising and tenderness in the bone, numbness or tingling, inability to move the affected limb or body part, etc.

What Is the Supracondylar Fracture of the Femur?

A distal fracture, also known as a supracondylar femoral fracture, occurs when the femur, or thigh bone, breaks at the knee. The femur or the thigh bone comprises a long and strong shaft in the middle and two rounded ends. The rounded ends are rounded protuberances known as condyles. Fractures of the femur above the condylar region are known as supra-condylar femur fractures. Femoral fractures, which include breaking the femoral head or neck, are typically experienced by older people. It is prevalent among older people because, with age, the bone becomes weak and also because of conditions like osteoporosis, etc. Younger people frequently experience it as a consequence of high-energy trauma, like a ladder fall or a car accident. Supracondylar fracture of the femur can cause excruciating pain and discomfort. Therefore, quick surgical intervention is advised.

What Are the Types of Supracondylar Fractures of the Femur?

The femur can get fractured at one or multiple places, which is why the supracondylar fractures of the femur are classified based on the affected area and type of fracture.

  • Transverse Fracture: The bone splits transversely or breaks straight all across.

  • Comminuted Fracture: In case of comminuted fracture, the thigh bone may break into multiple pieces.

  • Intra-Articular Fracture: In case of the intra-articular fracture goes all the way up to the knee joint, where it damages the knee cartilage.

What Causes Supracondylar Fractures of the Femur?

It takes a lot of force to break the femur because it is the largest and strongest bone in the body. The most common causes of supracondylar femoral fractures are blunt trauma from vehicle or motorcycle accidents, being struck by a car, or a major fall. Supracondylar fractures are frequent in older adults with osteoporosis (a condition that makes bone weak and brittle). Supracondylar femoral fractures can be severe in elderly patients. The fracture might spread into the knee joint, and the likelihood of the bone getting broken into numerous fragments is higher.

Who Is at Risk for Supracondylar Fractures of the Femur?

With osteoporosis and advanced age, the risk for supracondylar fractures of the femur is significantly increased. Other risk factors include:

  • Alcoholism.

  • Sedentary lifestyle and lack of physical activity.

  • Low body weight.

  • Poor nutrition and consuming a diet low in calcium and vitamin D.

  • Females are more likely to be affected by supracondylar fracture of the femur.

  • Tall stature causes stress-bearing areas to become more stressed.

  • Poor eyesight can cause a person to fall easily and be prone to accidents.

  • Alzheimer's disease and illnesses linked to mental impairment.

  • Some drugs may reduce bone density.

  • Residing in a facility for assisted care.

What Are the Symptoms of Supracondylar Fractures of the Femur?

The common symptoms of supracondylar fractures of the femur include the following:

  • A supracondylar femur fracture typically prevents the patient from bearing any weight on the affected limb.

  • Knee and occasionally thigh pain.

  • Tenderness in the affected bone.

  • Swelling or inflammation of the bone.

  • Bruising.

  • Deformed or misshapen bone.

How Are Supracondylar Fractures of the Femur Diagnosed?

In addition to a thorough medical history and physical examination, the following tests can be used to diagnose supracondylar fractures of the femur:

  • X-Rays: Low-level radiation is used in X-rays to get images of the bones. X-rays can reveal whether or not the bones are fractured.

  • CT (Computed Tomography) Scan: A cross-section of bone and tissue is produced by a CT scan using X-rays and a computer. It will indicate if the fracture is a simple break or multiple fractures.

  • Magnetic Resonance Imaging (MRI): These examinations of the body's soft tissues may be required to check for injury to the blood vessels as well as other soft tissues in the leg.

How Are Supracondylar Fractures of the Femur Treated?

Supracondylar femoral fractures can be treated surgically or non-surgically.

Non-Surgical Treatments:

  • Casts and Braces: Casts and braces can keep broken bones in place while they repair. However, the muscles in the thigh frequently tighten and pull the bone fragments apart in supracondylar femoral fracture. This is why unless the fracture is stabilized and the bone fragments are properly positioned, casts and braces might not be effective in treating this type of fracture.

  • Skeletal Traction: When the patient is in bed, a system of pulleys, weights, and counterweights holds the leg in a certain posture to keep the bone fragments together. This procedure is known as skeletal traction. As the bone heals, pins or screws may be used to hold it in the proper place.

Surgical Treatments: Since open fractures are susceptible to infection, surgery must be performed as soon as possible. However, in the case of a closed fracture, the surgical treatment can be planned a couple of days later to allow the doctor to carry out diagnostic tests and formulate a plan. Types of surgical treatments include the following:

  • External Fixation: The surgeon may employ an external fixator if the patient has additional medical issues and the muscles and skin require time to recover before surgery. The bones are held in place until surgery by a stabilizing framework on the exterior of the leg that is attached with pins and screws. When it is time for surgery, the surgeon will remove the external fixator and replace it with an internal fixator on the affected bone under the muscles.

  • Internal Fixation: The surgeon may set the bone using two common techniques. A metal rod called an intramedullary nail is inserted across the fracture to hold it in place, or the surgeon may use plates and screws to keep the broken pieces of bone together from the outside. A bone graft may also be used in certain cases, which is generally taken from the patient’s pelvis region. Moreover, some surgeons may also use artificial bone grafts to bridge the gap between the bones.

What Are the Complications of Supracondylar Fractures of the Femur?

Some of the complications of supracondylar fractures of the femur are:

  • Infections after surgery.

  • Nonunion of the fractured bone.

  • Misaligned union of the fractured bone.

  • Formation of blood clots or embolisms.

  • Muscular atrophy (wasting of muscular tissues).

  • Pneumonia.

Conclusion:

Supracondylar femur fractures can lead to depression, diminished quality of life, and a loss of independence, particularly in elderly patients. Additionally, recovery typically takes a while, especially for older individuals. Physical therapy and postoperative care are, therefore, crucial in these situations.

Frequently Asked Questions

1.

What Is the Classification of Supracondylar Fracture?

Supracondylar fractures occur in the humerus bone in the upper arm. The three types of supracondylar fractures are as follows:
Type 1: It is the most common type of supracondylar fracture. The transverse fracture line without any displacement of the bone fragments.
Type 2: The fracture line extends through the bone and may be displaced anteriorly or posteriorly.
Type 3: The most severe type involves complete displacement of the bone fragments. The fracture may be displaced in any direction and can be broken into multiple pieces.

2.

Do All Types of Supracondylar Fractures Require Surgery?

No, not all types of supracondylar fractures require surgery. The surgery depends on the type of fracture, the patient's age, and overall health status. Type 1 is usually treated with immobilization. Type 2 and 3 require surgery to stabilize the fracture and to realign the bone. Pins and screws are used to hold the bone fragments. 

3.

How Severe Is a Supracondylar Fracture?

The supracondylar fracture can be life-threatening. The severity depends on the degree of displacement and extent of injury. These fractures can be serious in children because the bone is in the growing and developing stages. These fractures can affect the growth and development of the child if not properly treated.

4.

What Is the Most Severe Complication of a Supracondylar Fracture?

The most severe complication is blood vessel and nerve damage. The complications are as follows:
- Blood Vessel and Nerve Damage: These fractures can cause arm muscle damage. This can result in muscle weakness, reduced sensation, or loss of function. 
- Compartment Syndrome: The condition in which pressure builds up in the nerve and muscles of the arm leading to swelling, pain, and tissue damage. 
- Volkmann’s Contracture: The condition characterized by permanent nerve and muscle damage leading to permanent loss of function.

5.

What Are the Other Names of Supracondylar Fractures?

The other names of supracondylar fractures are as follows:
- Elbow supracondylar fracture.
- Humerus supracondylar fracture.
- Distal humerus fracture.

6.

Which Artery Is Traumatized in Supracondylar Fracture?

The brachial artery gets injured in the case of a supracondylar fracture. The brachial artery is the vessel that supplies the arm. These fractures can cause the bone fragments to shift, leading to damage to the brachial artery. A reduced arm blood flow results in loss of sensation in the arm or tissue damage.

7.

What Is the Most Common Malformation in Supracondylar Fractures?

The common malformation is the displacement of the distal fragment of the humerus bone. The distal fragment can displace anteriorly or posteriorly. It allows the elbow to look deformed, which results in pain and swelling. The other deformities include rotation and angulation of the bone fragments. 

8.

Which Structures Are Injured in a Supracondylar Fracture?

The structures that are damaged in a supracondylar fracture are as follows:
- Bones are broken above the condyles.
- Damage to the nerve and blood vessels that run through that area.
- The brachial artery gets damaged.
Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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