Distal Femur Extraarticular fracture, simple

Nonoperative treatment; long leg cast then hinged knee brace

Long leg cast then hinged knee brace

Indication summary: Undisplaced fracture

Skill: Basic surgical experience, no specialized skills
Equipment: Basic equipment only

Most distal femoral fractures are treated surgically. Nonoperative treatment is reserved for exceptional cases, e.g., if the general medical condition does not allow safe anesthesia. If nonoperative treatment is selected, a long leg splint, followed by a hinged knee brace should be used to minimize limb shortening and to provide pain relief.

Indications

  • Medically unfit for surgery
  • Local soft-tissue compromise

Advantage

  • No need for anesthesia and its associated risks

Disadvantages

  • Continuing motion at the fracture site
  • Continuing soft-tissue compromise
  • Deformity of the fracture
  • Increased pain
  • Risk of malunion
  • Risk of nonunion

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

Appendix

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v1.0 2008-12-03