Abstract
Introduction: Distal femoral shaft and supracondylar fractures are now more common. Non-operative treatment of these challenging fractures is difficult and fraught with complications. Retrograde and supracondylar nails have emerged as a good alternative to stabilize these fractures. This study evaluates the outcome of retrograde femoral nails done over a span of 5 years at a University Hospital.
Materials and Methods: In this retrospective study, review of case notes and radiographs of 56 patients was done. All patients, who underwent retrograde and supracondylar femoral nailing between 1999 and 2003 were included. Various factors including patient demographics, mechanism of injury and fracture type were studied. Time to union, intra and post -operative complications and need for re-operation were also recorded.
Results: 41 retrograde and 15 supracondylar femoral nails were done in the study period. There were 16 males and 40 females. Most of the patients had sustained their fractures due to fall. 3 out of the 56 patients presented with open fractures. 53 patients had insertion of reamed nails and 52 of them had both ends locked. The average time of operation was 2 hours 10 minutes and the average blood loss was 500 ml. Most patients were mobilized early with partial weight bearing.
There were 3 superficial wound infections, which resolved with appropriate antibiotics. There were no cases of nerve damage or septic arthritis. 2 patients died with bronchopneumonia in the post- operative period.
55 out of 56 fractures united at an average of 16 weeks. 1 patient required re-operation for non-union, 9 months after the index operation.
Conclusion: We conclude from this study that there is a high union rate of distal femoral fractures treated with supracondylar and retrograde nails with very low complication rate. It allows early mobilization, particularly in elderly patients and seems to produce very good functional outcome with low re-operation rate.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
