Supracondylar femur fractures treated percutaneously

One hundred twenty-five supracondylar fractures in 118 patients treated with the Green-Seligson-Henry supracondylar intramedullary nail were evaluated. One hundred four patients (111 fractures) were followed up to fracture union. The percutaneous technique was compared with open reduction and internal fixation using the same device. The mean operative time was greater for the open reduction technique when compared with the percutaneous technique (176 minutes versus 76.6 minutes, respectively), as was the mean estimated blood loss (229 cc versus 96.2 cc). The incidence of delayed union was approximately the same for patients who were treated with both techniques. However, the nonunion rate was significantly higher in the patients treated with open reduction and internal fixation than the patients treated with the percutaneous technique (5.6% versus 2.6%). Twenty-nine (39%) patients who were treated with open reduction and internal fixation required bone grafting versus only three (7%) patients who were treated with the percutaneous technique. Additionally, the percutaneous technique did not produce a higher incidence of malalignment and resulted in a greater postoperative range of motion than the open technique. The current study shows that percutaneous treatment of supracondylar femur fractures is possible and can decrease operative times, blood loss, the need for bone grafting, increase rates of union, and improve functional outcomes.