English

Abstract

BACKGROUND: This prospective consecutive case series was done to evaluate indications, technical pearls and pitfalls and functional outcomes of distal femoral supracondylar fractures treated with retrograde intramedullary nailing. METHODS: The surgical outcome of 80 patients (59 males and 21 females) who were treated with retrograde intramedullary nailing for. Patients were followed-up both clinically and radiologically every 6 weeks for a mean duration of 20 (12 - 24) months. The patients were assessed based on Schatzker and Lambert criteria. RESULTS: The mechanism of injury was motor vehicle accident in 48 (60%) patients and fall in 32 (40%) patients. Sixty four (80%) fractures were closed and 16 (20%) fractures were compound. Average operation time was 2 hours and average blood loss was 300 ml. The mean union time was 5.6 months (5 - 7 months). Knee flexion of more than 120 degree was achieved in 60 patients, 110 degree in 16 patients and 100 degree in 2 patients. Six patients had anterior knee pain of transient nature which subsided within one year after rehabilitation, full weight bearing and self exercises. By the end of 1 year, overall outcome was excellent in 59 patients (74%), good in 12 patients (15%) and fair in 8 (10%) patients. CONCLUSION: Retrograde intramedullary femoral nailing is an optimal tool in the treatment of AO/ASIF type A and type C distal femur (supracondylar) fractures. It provides rigid fixation in a region of femur where, wide canal, thin cortices and frequently poor bone stock make fracture fixation difficult. It also provides excellent results in selected comminuted fractures of the distal femur with a low complication rate.