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Authors

Florian Gebhard, Phil Kregor, Chris Oliver, Markku T Nousiainen

Executive Editor

Chris Colton, Richard Buckley

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33C1   Complete articular fracture, simple articular, simple metaphyseal

General considerations

These are complete articular fractures with simple components to both articular and metaphyseal areas. It must be remembered that approximately 1/3 of patients with a sagittal split will additionally have a frontal plane fracture (Hoffa fracture; making it a multifragmentary articular injury).

Complete articular fractures of the distal femur are either the result of high energy trauma in the younger patient, or simple falls in the elderly, osteoporotic patient.

A simple articular split with a simple metaphyseal component is most commonly seen in the young individual and it is rare in the osteoporotic elderly patient, in whom there is generally significant comminution. The patella may commonly obscure a minimally displaced intraarticular split. For this reason, if there is ever a question of an intraarticular split, oblique radiographs or a CT scan is helpful.

33C1.1 Above transcondylar axis

33C1.1 Above transcondylar axis

X-ray taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.

33C1.1 Above transcondylar axis X-ray

33C1.3 Through or below transcondylar axis

33C1.3 Through or below transcondylar axis

X-ray taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.

33C1.3 Through or below transcondylar axis -X-ray