Open Reduction and Internal Fixation of Distal Femoral Fractures in Children Periprocedural Care

Updated: Sep 18, 2017
  • Author: Jeffrey D Thomson, MD; Chief Editor: Dinesh Patel, MD, FACS  more...
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Periprocedural Care

Equipment

Depending on the quality of bone, the surgeon’s experience, and the patient’s clinical scenario, the necessary equipment for fixation for supracondylar femur fractures includes the following:

  • Solid intramedullary nails
  • Flexible intramedullary nails
  • Kirschner wires (K-wires)
  • Steinmann pins
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Patient Preparation

Anesthesia

General anesthesia is used for complete muscle relaxation to facilitate anatomic fracture reduction.

Positioning

Patient is positioned supine on a flat-top radiolucent table to allow C-arm imaging. An ipsilateral bump is placed underneath the hip to allow some internal rotation to gain lateral exposure to the distal femur. This positioning is suitable for plating, crossed K-wires, or external fixation procedures of the distal femur.

For cases involving flexible or solid intramedullary nails, a fracture table can be used.

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Monitoring & Follow-up

Radiography at regular intervals is necessary to assess fracture healing. Patients may be seen initially at 2 weeks postoperatively and subsequently at monthly intervals until the fracture is healed.

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