P. Krishna Reddy1, J. Praneeth2
BACKGROUND: Supracondylar and intercondylar femoral fractures are serious injuries and difficult to treat and have potential to produce significant long term disability with poor results. Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. It is now recognized that distal femoral fractures are best treated with open/closed reduction and surgical stabilization. Many studies show retrograde intramedullary nailing is the best option. Our aim in this study is to evaluate surgical, radiological and functional outcome of retrograde intramedullary nailing in of distal femoral fractures.
. METHODOLOGY: 30 patients were including in the study. All the patients were treated with RIN and evaluated between May 2009 to September 2012 at Tertiary Care Hospital, Nellore. Modified knee rating system was used to assess functional outcome. Descriptive statistics were used to analyze the data. All the patients were followed up until fracture union occurred.
. RESULTS: Out of 30 patients, 21 male, 9 female, the mean age was 45±10 years. 15 were supracondylar and 5 intercondylar fractures. 28 simple and 2 cases were compound fractures 27 cases were due to RTA and 3 are due to fall. Radiologically 90% were type A fractures and 10% were type C fractures. The reported musculoskeletal trauma 66.3% of type A; 33.7% type C. Closed nailing was done in 9 patients of which 71% had excellent to good results and 29% had fair to poor results. In patients who underwent open nailing (21) 80% had excellent to good results and 20% had fair to poor results. The average range of motion was 105±10 degrees. There were no non-unions, one patient developed knee stiffness and one patient developed super infection which was the caused delayed union. The average time for union was 15.0±1.2 week. The duration of follow up was 6-28 months
CONCLUSION: Supracondular nail is the best implant to treat extra articular distal femoral and intra articular fractures without communication. Patient’s suffering with distal femoral fracture has a high mortality rate and surgical intervention seems to improve both mobility and mortality. The open nailing also gives better results than close nailing.