Fractures of the lower end of the femur
For fractures of the lower end of femur fractures include femoral condyles. These fractures are intraarticular, as is usually the fracture line enters the cavity of the knee joint. The most common fractures of the femoral condyles occur in the elderly. There is a traumatic injury with a direct blow to the knee or a fall on his knee.
Broken may be one or both condyles. The turning point may be offset or no offset. Usually condyles move up or down and away. Because of the lower end of the femur bone is well supplied with blood, fractures appear excessive bleeding. The blood thus collected in the cavity of the knee joint (hemarthrosis).
The patient complains of pain in the knee and lower thigh. The knee joint is increased in size. Patella with palpation becomes excessively mobile.
At the turn of the outer condyle deviates outward leg, and at the turn of the internal condyle of the tibia medially there is a deviation. Sometimes, the complex lines of fracture, there is a shortening of the limb. Attempts to limb movement in the knee joint are sharply painful. Movement is limited. The diagnosis is established by X-ray images.
Treatment. First of all, is carried out anesthesia. In the presence of blood in the knee joint, it is removed through a puncture of the joint. Joint capsule punctured with a needle in a certain place, blood is removed and injected into the joint of 10-15 ml of Novocaine. If bias is found, the plaster cast is applied, which is called a spica, from groin to ankle. The knee joint and it should be bent at an angle of 170 degrees. The duration of immobilization of up to 4 weeks. After removing the bandage is assigned physiotherapy.
If there is displacement of fragments is carried out and compared (reduction). Reposition is performed under local anesthesia or, more likely, under the conduction anesthesia, simultaneously. Seek matching fragments by setting the leg in a certain position. After reaching the comparison of fragments applied plaster cast for 4 weeks.
If we compare the fragments can not resort to surgery. Joint cavity is opened, blood clots and small fragments are removed. Broken off to the condyle of the femur is fixed with screws. After rapid fixation of bone fragments are superimposed two plaster splint for up to 3 weeks. Then assigned to physiotherapy. Full load on the limb can be a 2.5-3 months.
It is used as skeletal traction. Inserting wire carried through the tuberosity of the tibia. Needle attached to the bracket and cargo weighing up to 5kg. Is added and the cutaneous extension of the hip up to 3 kg. From the earliest days of motion shall be appointed in the knee joint in order to avoid infringement of its functions. Terms of skeletal traction for about two months. Full load on the limb can be 5-6 months. They are also used percutaneous osteosynthesis devices. Currently, the most commonly used surgical methods for treating fractures of the condyles, because they give the best results and shorten treatment time.
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