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Distal Femur Fracture
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Supracondylar femur fracture
              • Femoral condyle fracture
              • Periprosthetic distal femur fracture
            • Definitions

              • Fracture of femoral condyles &/or distal femoral metaphysis, ± intraarticular extension

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Reporting Tips

                                      Selected References

                                      1. Rice OM et al: Acute distal femoral replacement for fractures about the knee in the elderly. Orthop Clin North Am. 51(1):27-36, 2020
                                      2. Davis JT et al: Posttraumatic arthritis after intra-articular distal femur and proximal tibia fractures. Orthop Clin North Am. 50(4):445-59, 2019
                                      3. Hake ME et al: Modern implant options for the treatment of distal femur fractures. J Am Acad Orthop Surg. 27(19):e867-75, 2019
                                      4. Sain A et al: Dual plating of the distal femur: indications and surgical techniques. Cureus. 11(12):e6483, 2019
                                      5. Virkus WW et al: Intramedullary nailing of periarticular fractures. J Am Acad Orthop Surg. 26(18):629-39, 2018
                                      6. Piétu G et al: Minimally invasive internal fixation of distal femur fractures. Orthop Traumatol Surg Res. 103(1S):S161-9, 2017
                                      7. Little RM et al: Physeal fractures about the knee. Curr Rev Musculoskelet Med. 9(4):478-86, 2016
                                      8. White EA et al: Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Skeletal Radiol. 44(1):37-43, 2015
                                      9. Ehlinger M et al: Distal femur fractures. Surgical techniques and a review of the literature. Orthop Traumatol Surg Res. 99(3):353-60, 2013
                                      10. Ricci W: Classification and treatment of periprosthetic supracondylar femur fractures. J Knee Surg. 26(1):9-14, 2013
                                      11. Johnston AT et al: Periprosthetic fractures in the distal femur following total knee replacement: a review and guide to management. Knee. 19(3):156-62, 2012
                                      12. Chettiar K et al: Supracondylar periprosthetic femoral fractures following total knee arthroplasty: treatment with a retrograde intramedullary nail. Int Orthop. 33(4):981-5, 2009
                                      13. Kolb K et al: The condylar plate for treatment of distal femoral fractures: a long-term follow-up study. Injury. 40(4):440-8, 2009
                                      14. Smith EL et al: Supracondylar femur fracture after knee manipulation: a report of 3 cases. Orthopedics. 32(1):18, 2009
                                      15. Herrera DA et al: Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981-2006). Acta Orthop. 79(1):22-7, 2008
                                      16. Hutchinson PH et al: Complete and incomplete femoral stress fractures in the adolescent athlete. Orthopedics. 31(6):604, 2008
                                      17. Ross K et al: Bilateral femoral supracondylar stress fractures in a cross country runner. Orthopedics. 31(8):803, 2008
                                      18. Wu CC: Femoral supracondylar malunions with varus medial condyle and shortening. Clin Orthop Relat Res. 456:226-32, 2007
                                      19. Gocke TV: Case of the month. Salter-Harris type I fracture to the supracondylar femur physis. JAAPA. 19(10):72, 2006
                                      20. Su ET et al: A proposed classification of supracondylar femur fractures above total knee arthroplasties. J Arthroplasty. 21(3):405-8, 2006
                                      21. Abendschein W: Periprosthetic femur fractures--a growing epidemic. Am J Orthop. 32(9 Suppl):34-6, 2003
                                      22. Smith NC et al: Supracondylar fractures of the femur in children. J Pediatr Orthop. 21(5):600-3, 2001
                                      23. Stover M: Distal femoral fractures: current treatment, results and problems. Injury. 32 Suppl 3:SC3-13, 2001
                                      24. Seligson D: Treatment of supracondylar fractures of the femur. J Trauma. 49(2):360, 2000
                                      25. Muralikuttan KP et al: Supracondylar stress fracture of the femur. Injury. 30(1):66-7, 1999
                                      26. Schatzker J: Fractures of the distal femur revisited. Clin Orthop Relat Res. (347):43-56, 1998
                                      27. Albert MJ: Supracondylar fractures of the femur. J Am Acad Orthop Surg. 5(3):163-71, 1997
                                      28. Marsh JL et al: Supracondylar fractures of the femur treated by external fixation. J Orthop Trauma. 11(6):405-10; discussion 411, 1997
                                      29. Karpman RR et al: Supracondylar femoral fractures in the frail elderly. Fractures in need of treatment. Clin Orthop Relat Res. (316):21-4, 1995
                                      30. Newman JH: Supracondylar fractures of the femur. Injury. 21(5):280-2, 1990
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Supracondylar femur fracture
                                                  • Femoral condyle fracture
                                                  • Periprosthetic distal femur fracture
                                                • Definitions

                                                  • Fracture of femoral condyles &/or distal femoral metaphysis, ± intraarticular extension

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • Staging, Grading, & Classification

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Rice OM et al: Acute distal femoral replacement for fractures about the knee in the elderly. Orthop Clin North Am. 51(1):27-36, 2020
                                                                          2. Davis JT et al: Posttraumatic arthritis after intra-articular distal femur and proximal tibia fractures. Orthop Clin North Am. 50(4):445-59, 2019
                                                                          3. Hake ME et al: Modern implant options for the treatment of distal femur fractures. J Am Acad Orthop Surg. 27(19):e867-75, 2019
                                                                          4. Sain A et al: Dual plating of the distal femur: indications and surgical techniques. Cureus. 11(12):e6483, 2019
                                                                          5. Virkus WW et al: Intramedullary nailing of periarticular fractures. J Am Acad Orthop Surg. 26(18):629-39, 2018
                                                                          6. Piétu G et al: Minimally invasive internal fixation of distal femur fractures. Orthop Traumatol Surg Res. 103(1S):S161-9, 2017
                                                                          7. Little RM et al: Physeal fractures about the knee. Curr Rev Musculoskelet Med. 9(4):478-86, 2016
                                                                          8. White EA et al: Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Skeletal Radiol. 44(1):37-43, 2015
                                                                          9. Ehlinger M et al: Distal femur fractures. Surgical techniques and a review of the literature. Orthop Traumatol Surg Res. 99(3):353-60, 2013
                                                                          10. Ricci W: Classification and treatment of periprosthetic supracondylar femur fractures. J Knee Surg. 26(1):9-14, 2013
                                                                          11. Johnston AT et al: Periprosthetic fractures in the distal femur following total knee replacement: a review and guide to management. Knee. 19(3):156-62, 2012
                                                                          12. Chettiar K et al: Supracondylar periprosthetic femoral fractures following total knee arthroplasty: treatment with a retrograde intramedullary nail. Int Orthop. 33(4):981-5, 2009
                                                                          13. Kolb K et al: The condylar plate for treatment of distal femoral fractures: a long-term follow-up study. Injury. 40(4):440-8, 2009
                                                                          14. Smith EL et al: Supracondylar femur fracture after knee manipulation: a report of 3 cases. Orthopedics. 32(1):18, 2009
                                                                          15. Herrera DA et al: Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981-2006). Acta Orthop. 79(1):22-7, 2008
                                                                          16. Hutchinson PH et al: Complete and incomplete femoral stress fractures in the adolescent athlete. Orthopedics. 31(6):604, 2008
                                                                          17. Ross K et al: Bilateral femoral supracondylar stress fractures in a cross country runner. Orthopedics. 31(8):803, 2008
                                                                          18. Wu CC: Femoral supracondylar malunions with varus medial condyle and shortening. Clin Orthop Relat Res. 456:226-32, 2007
                                                                          19. Gocke TV: Case of the month. Salter-Harris type I fracture to the supracondylar femur physis. JAAPA. 19(10):72, 2006
                                                                          20. Su ET et al: A proposed classification of supracondylar femur fractures above total knee arthroplasties. J Arthroplasty. 21(3):405-8, 2006
                                                                          21. Abendschein W: Periprosthetic femur fractures--a growing epidemic. Am J Orthop. 32(9 Suppl):34-6, 2003
                                                                          22. Smith NC et al: Supracondylar fractures of the femur in children. J Pediatr Orthop. 21(5):600-3, 2001
                                                                          23. Stover M: Distal femoral fractures: current treatment, results and problems. Injury. 32 Suppl 3:SC3-13, 2001
                                                                          24. Seligson D: Treatment of supracondylar fractures of the femur. J Trauma. 49(2):360, 2000
                                                                          25. Muralikuttan KP et al: Supracondylar stress fracture of the femur. Injury. 30(1):66-7, 1999
                                                                          26. Schatzker J: Fractures of the distal femur revisited. Clin Orthop Relat Res. (347):43-56, 1998
                                                                          27. Albert MJ: Supracondylar fractures of the femur. J Am Acad Orthop Surg. 5(3):163-71, 1997
                                                                          28. Marsh JL et al: Supracondylar fractures of the femur treated by external fixation. J Orthop Trauma. 11(6):405-10; discussion 411, 1997
                                                                          29. Karpman RR et al: Supracondylar femoral fractures in the frail elderly. Fractures in need of treatment. Clin Orthop Relat Res. (316):21-4, 1995
                                                                          30. Newman JH: Supracondylar fractures of the femur. Injury. 21(5):280-2, 1990