- Discussion:
- few indications, except in elderly and osteoporotic patients w/ low energy extra-articular fractures;
- these fractures have a high rate of hardware failure w/ operative treatment;
- unfortunately, non operative treatment in elderly patients can also be associated w/ a high incidence of decubiti;
- Management:
- proximal tibial pins for traction;
- keep knee in 20-30 deg flexion;
- a hinged knee brace and knee flexion can be initiated when the frx becomes sticky;
- accept 7-10 deg of saggital coronal plane angulation;
- < 2 mm of articular frx
- Case Examples: (low energy supracondylar fractures in elderly patients which failed)
Supracondylar femoral fractures in the frail elderly. Fractures in need of treatment.
Supracondylar fracture of the femur: closed or open reduction?