Supracondylar fractures of the femur: results of treatment of 61 patients.

A retrospective study of 61 fractures (60 patients) involving the supracondylar and intercondylar areas of the femur was made. All patients were younger than 60 years and sustained their injuries in motor vehicle accidents. Follow-up was from 1 to 9 years (mean 30 months). Clinical results of operative and nonoperative treatment were compared with respect to knee motion, pain and function. Extra-articular (type A) fractures had superior clinical ratings if treated operatively (45% excellent and 30% unsatisfactory). Intra-articular (type B) fractures had a substantial number of unsatisfactory ratings (45%) and results of operative and nonoperative treatment were comparable. Fractures of one condyle only did best with open reduction and internal fixation. Rates of nonunion were low (7%); malunion in varus led to poorer overall function. The most important factor for acceptable function was early knee mobilization. Early motion of the knee and quadriceps rehabilitation are facilitated by operative management or use of the cast brace.