TREATMENT OF SUPRACONDYLAR FRACTURES OF THE FEMUR WITH ENDOMEDULLAR RETROGRADE INTERLOCKING NAIL

Abstract

INTRODUCTION AND OBJECTIVES

Classical treatment for supracondylar fractures of the femur has been osteosynthesis with plate and screws. This treatment is not free of complications as non-union, infection and material breakage. An alternative to this treatment is endomedullary osteosynthesis with retrograde interlocking nail.

MATERIALS AND METHODS

We have reviewed 7 supracongylar fractures of the femur in 6 patients, treated with SCN retrograde interlocking nail. The average age of patients was 73 years. Traffic accidents were responsible of 3 of the cases, and the other 4 were due to low energy traumatisms. None of the fracture was opened.

The average follow up was 20 months (17–27), and clinical results were evaluated according to the Hospital for Special Surgery (HSS) knee evaluation scale modified by Leung et al.

OPERATION TECHNIQUE

Patients were placed in the supine position, without any longitudinal traction. We performed an anterior access with parapatellar arthrotomy. All nails were locked both proximally and distally. Functional recovering of the limb in discharge began during postoperative period for an average of 12 weeks (6–20).

DISCUSSION AND CONCLUSIONS

The results were fully satisfactory. The use of intramed-ullary locking nail in these fractures provides several advantages over standard treatment with opened reduction and internal fixation with plates and screws Endomedullar nails have become the elective choice in shaft fractures of the femur, and with the use of interlocking nails, their indications have expanded to distal fractures of the femur. However, their use in supra and intercondylar fractures is not very expanded yet.