Supracondylar femur fracture fixation is an operation to stabilise a fracture of the lower thighbone just above the knee, using a locking plate or retrograde intramedullary nail.
For plating: an incision on the outer side of the lower thigh. A pre-contoured locking plate is applied along the lateral femur and fixed with multiple screws. For retrograde nailing: a nail is inserted through a small incision at the knee into the femoral canal. Both methods take one and a half to two hours.
Surgery is needed for displaced supracondylar femur fractures. These injuries are common in elderly patients with osteoporosis and in patients with existing knee replacements (periprosthetic fractures).
Rarely appropriate for displaced fractures. Traction is not a definitive treatment in adults.
Full-length femur X-rays. CT if the fracture extends into the knee joint. Assess for existing knee implants.
Restoration of femoral alignment and length allowing knee rehabilitation.
Very common. Early physiotherapy is essential.
Significant blood loss. Transfusion may be needed.
Significant thigh and knee swelling.
Risk approximately 5-10%, higher in elderly patients with poor bone quality.
Malalignment affecting gait.
Deep infection around metalwork.
Plate bending or screw pull-out in osteoporotic bone.
DVT or PE.
General or spinal anaesthesia.
Weight-bearing depends on fixation quality — restricted for six to twelve weeks in many cases. Knee range of motion exercises begin within the first few days. Full recovery six to twelve months.
X-rays at six weeks, three months, and six months.
They overlap significantly. 'Supracondylar' specifically refers to the area just above the femoral condyles. Treatment principles are the same.