M.E.Müller: Atlas: Fracture 33-A1

Femur, Distal,
extra-articular fracture,
simple 0,41% of the total
0,70% of the femur
11,44% of the segment

38 fractures
17,0% group
74%M, 26%F

113 fractures
50,7% group
56%M, 44%F

72 fractures
32,3% group
46%M, 54%F

Apophyseal avulsion +Q Metaphyseal oblique or spiral Metaphyseal transverse

These are extra-articular fractures of the distal femoral metaphysis with a simple spiral fracture line. They differ from the spiral fractures of the distal femoral diaphysis in that the center of the fracture line is in the metaphyseal area, where the cortices are much thinner. The presence of small fragments does not alter the classification. Ref. Manual of Internal Fixation:
226 - 269. 548 - 552.
Surgeon. RO.

The standard treatment is the internal fixation with the 95º condylar plate. The first step is the introduction of the blade into the condyles, well oriented in the three spatial planes. If the blade is placed parallel to the articular surface of the condyles and to their anterior plane, the plate will become parallel to the anatomical axis of the femoral diaphysis in the sagittal plane. The second step is the placement of the two distal cancellous screws, essential to supplement the fixation of the blade into the distal fragment. The diaphysis is then anatomically

reduced to the plate and fixed with cortical screws. In order to obtain interfragmentary compression, it is very important to place a lag screw in the center of the spires of both fragments. The use of a DCS implant has no biomechanical basis in the supracondylar fractures.

The use of cancellous bone graft is recommended if there is some bone stock loss, small fragments or if the reduction is less than perfect.

preoperative preoperative

postoperative postoperative

+ 4 months + 4 months

preoperative preoperative

+ 6 months + 6 months




						Femur, Distal, extra-articular fracture, simple	0,41% of the total 0,70% of the femur 11,44% of the segment






These are extra-articular fractures of the distal femoral metaphysis with a simple spiral fracture line. They differ from the spiral fractures of the distal femoral diaphysis in that the center of the fracture line is in the metaphyseal area, where the cortices are much thinner. The presence of small fragments does not alter the classification.		Ref. Manual of Internal Fixation: 226 - 269. 548 - 552. Surgeon. RO.

The standard treatment is the internal fixation with the 95º condylar plate. The first step is the introduction of the blade into the condyles, well oriented in the three spatial planes. If the blade is placed parallel to the articular surface of the condyles and to their anterior plane, the plate will become parallel to the anatomical axis of the femoral diaphysis in the sagittal plane. The second step is the placement of the two distal cancellous screws, essential to supplement the fixation of the blade into the distal fragment. The diaphysis is then anatomically	reduced to the plate and fixed with cortical screws. In order to obtain interfragmentary compression, it is very important to place a lag screw in the center of the spires of both fragments. The use of a DCS implant has no biomechanical basis in the supracondylar fractures. The use of cancellous bone graft is recommended if there is some bone stock loss, small fragments or if the reduction is less than perfect.