Supracondylar Femur FracturesPeihui Wuintroduction-definitionFrom the distal 7.6cm to the distal 15cm of the femur（distal the 1/3 of the femur）Fractures involve the supracondylar or intracondylar areas of the distal femurInjury mechanismlYoung persons(especially young men)：after high- energy traumalElderly persons(especially elderly women)：after low -energy injuries，DIAGNOSISTrauma history,swelling of the knee and supracondylar area, often obvious deformity , and marked tenderness on palpation。AP and lateral radiographs examination。PolyfracturedAssociated ligamentous disruptions of the knee jointConcern about vascularity to the lower extremity： Popliteal hematoma、 Dorsalis pedis artery pulse disappearAims of treatment Restoration of length, rotation; Restoration of axial alignment; Restoration of anatomic reconstitution of the articular surface (relative displacement less than 2 mm)Principles of surgical treatmentCareful handing of soft tissuesPreserve as much of the vascular supply to the fracture fragments as possible.Anatomic reduction of the articular surface and restoration of limb axial alignment, rotation, and length.Stable internal fixation, with bone grafting of defects where vascularity is impaired or where there is significant comminutionEarly and active functional rehabilitation of the patient and the limbIndication: simple fractureComplications included: DVTpressure sores, urinary andrespiratory infections, and orthopedic malunion ornonunion.Nonoperative treatmentPlateindicationsupracondylar or intracondylar fractures95condylar blade95condylar compression screwLISS (Less Invasive Stabilization System)Condylar plate95condylar blade1.5- 2cm6.5mm95condylar compression screw2cmCondylar buttress plateThis is not a fixed angle device Does not maintain correct axial alignment of the joint axis.LISS（Less Invasive Stabilization System）Retrograde interlocking intramedullary nailing(GSH)Indication and advantagesEspecially type A fractures.Soft tissue protection, less stress sheilding, compare to plate逆行交锁髓内钉disadvantage：An arthrotomy isneeded may cause knee septic arthritis and knee stiffnessBiomechanical relative weak compare to plate fixationsummarylType A DCS is preferredlType B 6.5 mm cancellous lag screwlType C DCS,LISS,GSH,Condylar buttress platetype C3 Condylar buttress plate with bone graft at medial side. attentionElderly patients with thin, osteoporotic bone and comminuted fractures：Rigid fixation is difficult to achieveThank you!Thank you!