Abstract
The femoral supracondylar and intercondylar fractures are difficult to be treated due to severe
soft tissue damage, comminution, intraarticular extension of fracture and injury to the
quadriceps mechanism frequently. The causes of nonunion are inadequate anatomical reduction,
fixation failure, bone defect and infection occasionally, which is difficult to be treated.
The authors analyzed 16 cases with nonunion of femoral supracondylar and intercondylar
fracture who had been treated surgicdlly from January 1990 to December 1991 According to
AO/ASIF classification in the initial fracture patterns, type A were 8 cases, type B was 1 case
and type C were 7 cases. The duration between initial treatment and surgical treatment of
nonunion was 6 months in average. The causes of nonunion were fixation failure due to
inadequate device selection in 9 cases, inadequate anatomical reduction or surgical technique in
4 cases and infection in 3 cases. The treatmentt were internal fixation with Dynamic condylar
screw(DCS) in 9 cases, internal fixation with condylar blade plate in 4 cases, monofocal
lenghtening with Ilizarov in 1 case and bifocal lenghtening with Ilizarov in 2 cases. According
to Schatzker classification, the good result was obtained in 11 cases(68.8%). The complications
were 3 knee joint ankyloses, 2 superficial wound infections, 1 delayed union and 1 deep vein
thrombosis.
In conclusion, the requirement for the good result in treatment of nonunion are exact
anatomical reduction, rigid fixation and autogenous bone graft.