To study the outcome of retrograde nailing in distal one-third femoral shaft fractures

Abstract

Objectives: With antegrade nailing, it is difficult to achieve perfect reduction of distal shaft femur fracture because of mismatch of size of medullary canal. Short juxta-articular segment is under the influence of deforming muscle forces and the large metaphyseal volume does not allow the intramedullary nail to have cortical contact that can aid in the reduction of the fracture. Distal femur fractures typically shorten and displace into recurvatum in the sagittal plane. In the coronal plane, the fractures have a tendency to displace or angulate according to the fracture morphology. This study was performed to assess the outcome of “Distal One-Third Shaft Femur Fracture” with Retrograde Intramedullary Interlocking Nail. Its intraoperative and postoperative complications and ease of surgery using retrograde intramedullary nailing. Using intraoperative time taken for completion of surgery and total number of C-Arm exposures.Materials and Methods: The study will include 30 cases with distal one third shaft femur fractures, who will undergo surgery using retrograde nail. Patients will be followed up for a period of 6 months at 1st, 3rd and 6th month. Patients will be assessed on the basis of Demographic analysis, Mode of injury, Classification of fracture based on AO Classification, Duration of surgery, number of C-ARM exposures, Outcome of fracture, Sagittal/Coronal plane deformity, Limb Length Discrepancy/Rotational, alignment, Range of motion. Pain, functional outcome of knee using lysholm knee score and Complications observed. Results: Two patients shows malalignment rest twenty patients had normal alignment. In our study radiological union was seen in 16(72.7%) patients and nonunion was observed in 6(27.3%) patients.Conclusion: We strongly recommend the use of Retrograde Intramedullary Nail with multiple distal locking options in the patients with distal one-third femoral shaft fractures, keeping the distal end of the nail in subchondral bone.