Fractures of the distal femur: the role of the Zickel supracondylar fixation device.

Supracondylar fractures of the femur are often difficult to manage, especially in the elderly whose osteoporotic bone renders internal fixation tenuous. The Zickel supracondylar device provides a dynamic, medullary fracture fixation secure enough to allow unsupported early mobilization even in the elderly. The device can be inserted through small incisions, minimizing surgical injury. Interlocking screws prevent shortening and rotation and allow its use even in comminuted fractures. In 16 patients with non-pathological fractures, follow-up was possible on 14. There were 7 excellent, 5 satisfactory and 2 unsatisfactory results. There were no failures. Follow-up ranged from 6 months to 2 years. The device also proved effective in four patients with pathological fractures, the closed insertion allowing the benefit of early radiotherapy. This small but varied series shows the value of the Zickel supracondylar device in this difficult fracture.