Executive Editor: Amy Kapatkin General Editor: Noel Moens

Authors: Mary Sarah Bergh

Distal Femur

back to skeleton

Glossary

Surgical procedures sorted by fracture type

Use this menu to jump directly into a specific classification (optional):
A1 A2 A3 B1 B2 B3 C1 C2 C3
A1

Extra-articular fracture, simple

Please select a treatment option:
Treatment Main indication Skill Equipment
Closed reduction Minimal displacement, early identification, small patient, reducible fracture Basic surgical experience, no specialized skills Basic equipment only
Cross pinning 33-A1 and 33-A2 fractures. Most stable if fracture configuration and reduction allow for interdigitation of fragments Basic surgical experience, no specialized skills Basic equipment only
Plate fixation To provide rigid fixation when adequate bone stock is available. Plates may be used in compression, neutralization, or bridging fashion Some specialized surgical experience Simple surgical and imaging resources
A2

Extra-articular fracture, wedge

Please select a treatment option:
Treatment Main indication Skill Equipment
Cross pinning 33-A1 and 33-A2 fractures. Most stable if fracture configuration and reduction allow for interdigitation of fragments Basic surgical experience, no specialized skills Simple surgical and imaging resources
Cross pinning and lag screw Reconstructible 33-A2 fractures with a large metaphyseal wedge fragment Basic surgical experience, no specialized skills Simple surgical and imaging resources
Neutralization plate Reconstructible 33-A2 fractures Some specialized surgical experience Simple surgical and imaging resources
Bridging plate Non-reconstructible fractures Some specialized surgical experience Simple surgical and imaging resources
A3

Extra-articular fracture, complex

Please select a treatment option:
Treatment Main indication Skill Equipment
Lag screw and neutralization plate 33-A3 fractures with a reconstructible fracture configuration Highly experienced and skilled surgeon Simple surgical and imaging resources
Bridging plate Non-reconstructible 33-A3 fracture configurations Highly experienced and skilled surgeon Simple surgical and imaging resources
External skeletal fixator Non-reconstructible 33-A3 fracture configurations Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B1

Partial articular fracture, lateral condyle, sagittal

Please select a treatment option:
Treatment Main indication Skill Equipment
Screw fixation Reconstructible 33-B1 fractures Some specialized surgical experience Simple surgical and imaging resources
B2

Partial articular fracture, medial condyle, sagittal

Please select a treatment option:
Treatment Main indication Skill Equipment
Screw fixation Reconstructible 33-B2 fractures Some specialized surgical experience Simple surgical and imaging resources
B3

Partial articular fracture, frontal, unicondylar

Please select a treatment option:
Treatment Main indication Skill Equipment
Screw fixation Reconstructible 33-B3 fractures Some specialized surgical experience Simple surgical and imaging resources
C1

Complete articular fracture, metaphyseal simple or wedge

Please select a treatment option:
Treatment Main indication Skill Equipment
Cross pinning and transcondylar lag screw Reconstructible 33-C1 fractures Highly experienced and skilled surgeon Simple surgical and imaging resources
Transcondylar lag screw and neutralization plate To achieve anatomical reconstruction of joint surface, bridging fixation to diaphysis Highly experienced and skilled surgeon Simple surgical and imaging resources
C2

Complete articular fracture, metaphyseal complex

Please select a treatment option:
Treatment Main indication Skill Equipment
Transcondylar lag screw and neutralization plate Reconstructible 33-C2 fractures Highly experienced and skilled surgeon Simple surgical and imaging resources
C3

Complete articular fracture, multifragmentary

Please select a treatment option:
Treatment Main indication Skill Equipment
Dynamic cross pinning and transcondylar lag screw Reconstructible 33-C3 fractures Highly experienced and skilled surgeon Simple surgical and imaging resources
Transcondylar lag screw and bridging plate Non-reconstructible 33-C3 fractures, to achieve anatomical reconstruction of joint surface, bridging fixation to diaphysis Highly experienced and skilled surgeon Simple surgical and imaging resources
*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

1.0 2019-01-15