33A2 Extraarticular fracture, simple
General considerations
Simple extraarticular fractures are characterized by a single circumferential disruption of the diaphysis, this may be oblique, spiral or transverse.
Careful inspection of radiographs should be undertaken to ensure that intraarticular extensions are not missed. Traction radiographs, oblique radiographs, or a CT scan may help to elucidate occult articular extensions. Surgeons should always be aware that it may not be until during surgery that an occult intraarticular extension is discovered and that they may need to deal with such a fracture by reducing and fixing the articular surface using a lag screw technique.
33A2.1 Spiral
These fractures can result from relatively low energy, twisting forces to distal femur. They are often seen in osteoporotic, elderly patients.
33A2.2 Oblique
These fractures can result from relatively low energy, twisting forces to distal femur. They are often seen in osteoporotic, elderly patients.
33A2.3 Transverse
These fractures can result from higher energy injuries in younger patients.
X-ray by courtesy of Spital Davos, Switzerland, Dr C Ryf and Dr A Leumann.
