Bone cement as an adjunct to medullary nailing in fractures of the distal third of the femur in elderly patients

Abstract

A modified method of internal fixation for fractures of the distal third of the femur in elderly patients is discussed. The procedure is also recommended for fractures due to secondary neoplasia. The method consists of medullary nailing with insertion of acrylic bone cement into the medullary canal. A series of 14 patients is presented, with an average age of 79.4 years, range 62-99 years (Table I). Two patients had suffered pathological fractures from myelomatosis; the other fractures involved the distal third of the femur which were often comminuted and/or in osteoporotic bone, thus rendering them unsuitable for more orthodox methods of fixation. Emphasis is placed on the possibility of early activity and the facilitation of nursing patients for whom long periods of rest in bed and traction should be avoided.