A Clinical Study Of Distal Femoral Fractures Treated By Retrograde Femoral Nailing – Biological And Biomechanical Advantages With Review Of Literature
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 2
Abstract
Background: Distal femoral fractures with or without intra-articular extension are often difficult to treat as they are usually associated with a high incidence of complications like knee stiffness, quadriceps wasting, knee instability, mal-union, non-union, joint incongruity, shortening and osteoarthritis. The management of these fractures by retrograde femoral nailing has the advantages of preservation of fracture hematoma, decreased blood loss, minimal soft tissue dissection, early mobilization and less post-operative complications. The present study aims to evaluate the results of distal femoral fractures treated by open/closed reduction and internal fixation using a retrograde femoral nail. Methods: 30 patients with distal femoral fractures were studied. Cases were selected on the basis of purposive sampling technique. Demographic details such as age, sex, occupation, pre-fracture activity levels and type of fracture were recorded. All patients were treated by closed or open retrograde femoral nailing. Patients were followed up for 12-36 months and follow-up data such as time to union, range of knee movements and complications were noted. Results: Assessment of final functional result was made using Lysholm knee scoring scale. 73% of our patients had excellent or good functional results. The average knee range of movement was 1060(Range: 90-1200) and the average time to union was 16 weeks (Range: 12-20 weeks). Conclusion: Retrograde femoral nailing is an effective method for treatment of extra-articular and some selected intra-articular distal femoral fractures with advantages of reduced operative time, reduced blood loss and low incidence of complications like infection and knee stiffness. Early surgery, achieving closed reduction and early post-operative knee mobilization are essential for prompt union and good knee range of motion.
Authors and Affiliations
Shrihari LK, Sunil Mannual, Sapan DS
Keywords
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