Supracondylar Femur Fractures Guidelines

Updated: Jan 24, 2023
  • Author: Steven I Rabin, MD, FAAOS; Chief Editor: Jeffrey D Thomson, MD  more...
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Guidelines Summary

COVID-19 pandemic guidelines

On March 24, 2020, the American College of Surgeons published COVID-19 guidelines for triage of orthopedic patients. The general recommendations for all surgical cases include the following [54] :

  • Provide appropriate and timely surgical care based on sound surgical judgment and availability of resources
  • Consider nonoperative management whenever it is clinically appropriate for the patient
  • Consider waiting on results of COVID-19 testing in patients who may be infected
  • If possible, avoid emergency surgical procedures at night when staff may be more limited
  • Aerosol generating procedures (AGPs) increase risk to the health care worker; for patients who are or may be infected, AGPs should only be performed while wearing full PPE including an N95 mask or powered, air-purifying respirator (PAPR) that has been designed for the operating room 

During phase II, hospitals have many COVID-19 patients, intensive care unit (ICU) and ventilator capacity are limited, or supplies are limited or the COVID-19 trajectory within the hospital is in a rapidly escalating phase. For trauma patients during this phase, the guidelines recommend restricting orthopedic procedures to new fractures, acute traumatic injury, nonunions, malunions and infections.

During phase III, hospital resources are all routed to COVID-19 patients, there is no ventilator or ICU capacity, or supplies have been exhausted. For trauma patients during this phase, the guidelines recommend restricting orthopedic procedures to new fractures, quad tendon rupture, patellear tendon rupture and acute changes of a chronic injury with inability to function.