Distal Femur Fracture Of The Knee

by Administrator 21. March 2017 10:34

Fracture refers to a break or a crack in one or more bones in any part of the body. The distal femur is the lower part of the thigh bone that connects to the knee joint. This bone has a shape like that of an inverted funnel and it joins the shin bone (lower leg) to support the body weight and allow movement. They are supported by the quadriceps muscle, hamstring muscles, a group of tendons and ligaments and a thick layer of articular cartilage which acts as shock absorber and prevents the bones from rubbing against each other.

A break in this part of the bone is referred to as the Distal Femur Fracture of the Knee and it is a rare type of injury that affects the elderly and young people who indulge in high impact sports. In some cases the patella or the knee cap also gets damaged along with the femur. The tendons and ligaments may also be damaged in the process. Sometimes the ligaments snap resulting in shortening of the muscle length. Distal Femur Fractures can be categorized as follows:

  • Transverse Fracture-  the break in the bone is observed to be straight across the bone
  • Comminuted Fracture- the bone tends to break into many pieces
  • Intra-articular Fracture- this type of fracture extends into the knee joint and damages the articular cartilage

Causes

  • Osteoporosis- people above the age of 50 years are likely to have weaker bones due to lack of calcium and general wear and tear with age. The weak bones are likely to crack easily
  • A fall from a height or a sudden fall
  • Vehicular accidents that impact the knee joint
  • Sports injuries
  • Direct hit to the knee joint or the thigh

Symptoms

  • Severe pain may set in immediately after the injury and it is generally persistent
  • Swelling, redness and tenderness around the joint and the thigh may be observed
  • Inability to bear body weight
  • Visible deformity may occur with a part of the bone sticking out of a wound in case of open fractures
  • Bruising and discoloration
  • Altered gait
  • Joint instability
  • Limited range of motion

Diagnosis

  • A detailed clinical evaluation by an orthopedic should be conducted immediately
  • The doctor will check for additional damage to other body parts
  • Details of the mode of injury and medical history of the patient are taken into consideration
  • Check for loss of blood supply or nerve sensation in the leg, feet and thigh
  • X-ray imaging helps diagnose the location and severity of fracture
  • The doctor will look for open wounds and infection that may have passed through it
  • MRI and CT scans may be required

Treatment

Distal Femur Fractures can be treated both surgically and non-surgically depending on the severity of the injury. The methods employed include:

  • Mechanical traction of the skeletal framework with weights and pulleys to bring the bone back in its original position. This is also referred to as manual reduction
  • Bones that are stable with a slight crack or break can be treated by placing the leg in a plaster for a few weeks
  • Immobilization- recommended use of a brace or a cast to keep the bone stable and promote healing
  • External fixation- metallic pins and screws may be used to hold the bone in place and these are attached to an external fixator to keep them stable
  • Internal fixation- a surgical method which involves insertion of a metal rod into the femur along with plates and screws to stabilize the broken bone
  • Severely damaged bone may require total replacement of the joint for best outcome
  • Bone graft by using a piece of bone extracted from other joints or artificial bone fillers may be induced to allow the bone to heal and solidify
  • Use of crutches or a walker is recommended post surgery
  • Activity modification and weight bearing needs to be avoided
  • Physical therapy is required to restore movement

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