The Old Supracondylar Fracture of Femur Treated by Gradual Deformity Correction Using the Ilizarov Technique Followed by the Second-Stage Internal Fixation in an Elderly Patient With Osteoporosis

Abstract

Background: The supracondylar nonunion of femur in elderly individuals is rare and challenging to manage. Nothing in English literatures or guidelines is available regarding this particular fracture characterized by osteoporosis, soft-tissue contracture, shortening, and joint stiffness. We report a case of an elderly patient with a supracondylar nonunion of the femur, which was successfully treated using staged Ilizarov techniques and dual plating. Case Presentation: An 84-year-old female patient was admitted to our orthopedic department for her pain and soft-tissue swelling around the right knee with claudication and shortening deformity of the affected extremity. She denied any specific history of trauma and had sought traditional Chinese medical attention for 6 months before she presented to our hospital. Diagnosis of the right femoral supracondylar nonunion was made based on the X-ray and computed tomography. Ilizarov external fixator was carried out for successive and slow distraction and gradual correction of the shortening deformity, in consideration of the nonunion was still present. Subsequently, internal fixation with dual plating of the distal femur was performed. Excellent function and patient satisfaction were observed at 6 months of follow-up. Conclusion: The protocol of Ilizarov technique with subsequent internal fixation of dual plating seems to be an efficient solution to the supracondylar nonunion of femur in elderly patients with osteoporosis. The advantage of the protocol is that it allows knee joint motion, avoids neurovascular complications, and gentle correction of soft-tissue contractures.

Role of microsurgical techniques combined with Ilizarov techniques in limb salvage and functional reconstruction of thermal‑crush injuries of the hand: A case report

“…The Ilizarov treatment has been used clinically for a long time (32), and it was important in the reconstruction of hand function in the present case. The Ilizarov technique can effectively release and correct joint stiffness and flexion contractures without complex and dangerous release surgeries (33). At the same time, slow stretching of soft tissue can simultaneously correct defects in tendons, nerves, blood vessels and skin, avoiding complex micro repair and reconstruction surgeries (34).…”

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“…So, some frames were removed early while others were removed late. All the data were collected with the help of a proforma and then entered SPSS version 20 for analysis [5][6][7][8][9][10][11][12][13][14].…”