Femur, distal: extraarticular simple fracture—32-A1.3/33-A1.2

10.1055/b-0034-87646

Femur, distal: extraarticular simple fracture—32-A1.3/33-A1.2

Reto Babst

Case description

A 68-year-old woman fell from her standing height and presented to hospital the following day with pain and deformity of the left thigh. She was transferred to the author‘s hospital for definitive treatment of a left distal femoral shaft fracture extending into the medial condyle ( Fig 18.4-1 ) having been temporarily splinted in a plaster cast. The patient was in good general condition with well-controlled hypertension and a moderate bilateral knee gonarthrosis. She was independent and lived alone.

Indication for MIPO

The patient had local soft-tissue swelling with a significant hematoma and crepitus in the left thigh when she moved. Before the accident the patient suffered from slight pain in both knees from medial compartment arthrosis. Since the patient was in good general health, restoration of anatomy was considered using a MIPO procedure.

a–b Preoperative AP and lateral x-rays show a long spiral fracture in the distal third of the left femur with a nondisplaced fracture line at the distal fragment extending into the medial condyle.

Preoperative planning

A hand-drawn or computer-generated preoperative plan is recommended, including the approach, the applied reduction techniques, and the selected implant ( Fig 18.4-2 ).