Abstract
Aims: To evaluate the results of our preliminary experience with the retrograde nailing for distal femoral fractures. Methods: During the period 1997 Ð 2000, 39 patients with 43 fractures of the distal femur, treated with retrograde intramedullary nail. There were 10 periprosthetic, 2 nonunions after previous failed þxation and 1 pathological fracture. 12 fractures were extra-articular, 18 had intra-articular extension and 2 fractures were open Type II according to Gustillo classiþcation. The mechanism of injury was road trafþc accident in 15 cases, with 9 of those being polytrauma patients, simple fall in and 1 spontaneous fracture. Results: Union was achieved in 11,3 weeks average time. There were 2 mal-unions and 1 nonunion needed reoperation. From the rest of the patients there were 4 with an excellent functional score, 19 good and 2 fair results. There were one superþcial infection, treated conservatively. In one patient the metalwork removal was necessary because he complained of pain from the distal interlocking screws. Conclusions: Retrograde intramedullary nailing, appears to be a reliable technique to treat fractures of the distal femur. It is accompanied by a high union rate and a low infection rate. It offers the advantage of little soft tissue impairment and adequate stability necessary for the fracture healing. Blood loss is usually small and therefore the method is suitable for fracture treatment in elderly and polytrauma patients. The accuracy of the reduction remains a question, because there is no precise method to test it intraoperatively.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
