Fixator-Assisted Plating in Pediatric Supracondylar Femur Fractures

Purpose. Pediatric femoral supracondylar fractures are difficult to reduce by either closed or open reduction. The abnormal muscle forces around the knee tend to significantly displace the distal short metaphyseal fragment. We describe a novel technique utilizing the combination of a temporarily intraoperative external fixation in order to achieve and maintain the reduction followed by internal fixation. Method. Three male patients younger than 16 years of age were operated in our department. The fractures were defined as pathological in 2 patients. In order to facilitate and maintain fracture reduction, an external fixator was temporarily used intraoperatively; once the fractures were internally fixed, the fixator was removed. Results. Anatomical reduction was achieved in all patients. In an average follow-up of 2 years, all the fractures are solidly healed and the various bone lesions are healing. All patients have returned to regular physical activity. Conclusion. Difficult supracondylar femur fractures in children are easier to manipulate and reduce with the assistance of an intraoperative external fixator. Once the fracture is internally fixed and stable, the external fixator is removed.