M.E.Müller: Atlas: Fracture 33-C1

Femur, Distal, complete
articular fracture, articular simple,
metaphyseal simple 0,30% of the total
0,50% of the femur
8,46% of the segment

71 fractures
43,0% group
42%M, 58%F

68 fractures
41,2% group
28%M, 72%F

26 fractures
15,8% group
62%M, 38%F

T or Y-shaped, with slight displacement T or Y-shaped, with marked displacement T-shaped epiphyseal

These are complete articular fractures of the distal femur involving both the articular and the metaphyseal areas, with T or Y-shaped simple fracture lines, with slight displacement. Ref. Manual of Internal Fixation:
270 - 281. 548 - 552.
Surgeon. JM.

The treatment strategy for all of the fractures of the group C is to first reduce and fix the intercondylar fracture and then follow with the fixation of both condyles to the metaphyseal-diaphyseal area. The first operative goal is obtained with the use of two cancellous screws. The internal fixation of the supracondylar fracture can be performed either with a 95º condylar plate or with a DCS.

If a DCS is used, as in the illustrated case, its own sliding screw performs interfragmentary compression between the two condyles and one of the cancellous

screws may be avoided. Once the barrel of the side plate is slid over the large screw, the diaphysis can be reduced to the plate and the anatomic diaphyseal-articular line angle is obtained automatically.

In the illustrated case, several screws perform interfragmentary compression through the long spiral metaphyseal fracture line and, for that reason, many of the cortical screws placed through the plate could have been avoided.

preoperative preoperative

+ 4 months + 4 months




						Femur, Distal, complete articular fracture, articular simple, metaphyseal simple	0,30% of the total 0,50% of the femur 8,46% of the segment






These are complete articular fractures of the distal femur involving both the articular and the metaphyseal areas, with T or Y-shaped simple fracture lines, with slight displacement.		Ref. Manual of Internal Fixation: 270 - 281. 548 - 552. Surgeon. JM.

The treatment strategy for all of the fractures of the group C is to first reduce and fix the intercondylar fracture and then follow with the fixation of both condyles to the metaphyseal-diaphyseal area. The first operative goal is obtained with the use of two cancellous screws. The internal fixation of the supracondylar fracture can be performed either with a 95º condylar plate or with a DCS. If a DCS is used, as in the illustrated case, its own sliding screw performs interfragmentary compression between the two condyles and one of the cancellous	screws may be avoided. Once the barrel of the side plate is slid over the large screw, the diaphysis can be reduced to the plate and the anatomic diaphyseal-articular line angle is obtained automatically. In the illustrated case, several screws perform interfragmentary compression through the long spiral metaphyseal fracture line and, for that reason, many of the cortical screws placed through the plate could have been avoided.