Abstract
Aims and Objective: To study the incidence and pattern of supracondylar femur fractures according to AO/ASIF classification, to assess the treatment and long-term functional outcome for supracondylar femoral fracture using retrograde nail. Methods: In the present study twenty supracondylar femur shaft fractures were treated by retrograde nail. Of these, four were females and sixteen were males, in the age group of 20 to 70 years. Fractures were classified according to Mullers. 40% were Type A2 fractures, 20% were Type A3, 20% were Type C1, 15% were Type C2 and 5% were Type C3. All the cases were operated with retrograde intramedullary nailing using patellar splitting approach. Results: Most common mechanism of injury was motor vehicles accidents associated with high energy trauma 12 cases (60%). Five were open fractures whereas fifteen were closed. The fractures were comminuted in 30% cases whereas 30% presented with a transverse pattern. 25% were oblique fractures and only one spiral fracture occurred in our series. The average range of knee motion in our series was 92.5 degrees. Knee stiffness occurred in one patient of type C3 fracture. There were two cases of significant shortening, one was 1.8 cms and the other was 3.1 cms, both occurred in type C2 comminuted fractures, it did not cause any morbidity and was corrected by shoe raise. The risk of infection and non-union were low. The incidence and severity of significant malunion was nil. It offers a short hospital stay, early mobilization and predictable healing. Conclusion: Supracondylar nail is an excellent option for management of supracondylar femur fractures even in those with intercondylar extension.
Highlights
Supracondylar femur fractures are the most complex because of the soft tissue injury and the degree of comminution they involve
Many treatment modalities have been advocated for the treatment of the supracondylar fractures of the femur
The present study included supracondylar femur fractures, open as well as closed with or without intercondylar extension treated with the GSH supracondylar nail
Summary
Supracondylar femur fractures are the most complex because of the soft tissue injury and the degree of comminution they involve. The supracondylar region because of its complex anatomy, proximity to the knee joint, a major weight bearing joint, difficulty in control over distal fragment always possess a challenge to treat. To add to this, are the associated ligamenteous injuries, intra articular involvement and difficulty in anatomical alignment, which further complicated the treatment [1]. Many treatment modalities have been advocated for the treatment of the supracondylar fractures of the femur. The various methods of cast braces and reduction were advocated to decrease the period of immobilization. Non operative treatment of any form was always confounded with anatomical mal-alignment and knee stiffness
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