Supracondylar Fractures

A fracture occurs just proximal to the femoral condyles but may extend into the knee joint and damage the articular surface.

Mechanism of Injury

These fractures may arise from either direct or indirect violence, with the latter largely involving the patient falling to the ground or from a height onto his feet.

Classification

Supracondylar fractures are most commonly classified according to AO-ASIF classification:

• Extra-articular fracture
• A1 - simple
• A2 - metaphyseal, wedge
• A3 - metaphyseal, complex
• Partial articular surface
• B1 - lateral condyle
• B2 - medial condyle
• B3 - frontal
• Complete articular surface
• C1 - articular and metaphyseal segments, simple fragments
• C2 - articular simple, but metaphyseal multifragmentary fractures
• C3 - articular and metaphyseal segments, multifragmentary fractures.

Clinical Features

The knee is swollen, widened and deformed. Crepitus is present with both active and passive movements.

X-rays confirm the diagnosis. It is essential to include the femur into the x-ray. Often, the distal fragment is angulated posteriorly due to the action of the gastrocnemius muscle.