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Chapter 53 – Fractures of the Distal Femur

Christian Krettek, M.D.**
The author gratefully acknowledges the contributions made by David L. Helfet, M.D. to previous editions of this chapter, some of which have been retained.


Relevant Anatomy

The distal end of the femur traditionally encompasses the lower third of this bone. This zone varies greatly in the literature, from the distal 7.6 cm to the distal 15 cm of the femur. This chapter deals only with fractures that involve the supracondylar (metaphyseal) and intercondylar (epiphyseal) areas of the distal end of the femur. Distal femoral fractures that are purely diaphyseal are discussed in  Chapter 52.


The supracondylar (metaphyseal) area of the distal portion of the femur is the transition zone between the distal diaphysis and the femoral articular condyles (Fig. 53-1A). At the diaphyseal-metaphyseal junction, the metaphysis flares, especially on the medial side, to provide a platform for the broad condylar weight-bearing surface of …