Outcome of Retrograde Interlocking Nail in Supracondylar Femur Fracture
Keywords:
Retrograde Interlocking Nail, Outcome, Supracondylar Femur FractureAbstract
Objective: To determine the potential outcome of retrograde intramedullary nailing in supracondylar femur fractures in terms of fracture union and range of knee movement.
Methods: This descriptive case series study was conducted from June 2015 to November 2015. Study included 31 patients of either gender aged between 18-60 years presenting with supracondylar femoral fractures type 33A 1,2,3 which were fixed by retrograde interlocking nail technique using C-arm to make entry point and locking of nail. All patients were operated by one team in District Hospital Quarter Hospital Faisalabad. Outcome variable were frequency of union and functional outcome of knee range of motion
Results: The mean age of the patients was 38.77±9.70 years with a male to female ratio of 5:1. Radiological and clinical union was established in 30 (96.8%) patients at 24th post-operative week while 1 (3.2%) patient was labeled to have non-union. The range of knee flexion increased gradually from 99.94±9.98 degrees on 10th post-operative day to 122.13±8.64 degrees on 24th post-operative week
Conclusion: Retrograde interlocking nail is an effective treatment option for supracondylar femur fractures with excellent union rate and functional range of motion at knee
References
2. Dar GN, Tak SR, Kangoo KA, Halwai MA. Bridge plate osteosynthesis using dynamic condylar screw DCS or retrograde intrameduallary supracondylar nail (RIMSN) in the treatment of distal femoral fractures: comparison of two methods in a prospective randomized study. Ulus Travma Acil Cerrahi Derg 2009 Mar;15:148-53.
3. Thomson AB, Driver R, Kregor PJ. Long-term functional outcomes after intra-articular distal femur fracture: ORIF versus retrograde intramedullary nail ing. Orthopedics 2008 Aug;31:748-50.
4. Markmiller M, Konrad G, Sudkamp N. Femur-LISS and distal femoral nail for fixation of distal femoral fractures: are there differences in outcome and complications? Clin Orthop Relat Res 2004 Sep;426:252-7.
5. Morgan SJ, Hurley D, Agudelo JF. Retrograde femoral nail ing: an understanding of the intercondylar insertion site. J Trauma 2006 Jan;64:608151-4.
6. Kawy SE, Ansara S, Moftah A, Shalabi H, Varughese V. Retrograde femoral nailing in elderly patients with supracondylar fracture femur; is it the answer for a clinical problem? Int Orthop 2007 Feb;31:83-6.
7. Zlowodki M, Williamson S, Cole PA, Zardiackas LD, Kregor PJ. Biomechanical evaluation of the less invasive stabilization system, angled blade plate, and retrograde intramedullary nail for the internal fixation of distal femur fractures. J Orthop Trauma 2004 Sep;18:494-502.
8. Christodoulou A, Terzidis I, Ploumis A, Metsovitis S, Koukoulidis A, Toptsis C. Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screw and the retrograde intramedullary nail: a comparative study of the two methods. Arch Orthop Trauma Surg. 2005 Mar;125:73-9.
9. Nathan H, Ian H, Kaushik H. Retrograde nailing versus fixed-angle blade plating for supracondylar femoral fractures: A randomized controlled trial. ANZ J Surg 2006 May;76:290-4.
10. Gonzalez Della Valle A, Leali A, Hass S. Etiology and surgical interventions for stiff total knee replacements. HSS J 2007 Sep;3:182-9.
11. Engh GA, Ammeen DJ. Perioprosthetic fractures adjacent to total knee implants: treatment and clinical results. Instr course Lect 1998 Jul;47:437-48.
12. Moehring HD. Flexible intramedullary fixation of femoral fractures. Clin Orthop 1988 Dec;277:190-200.
13. Zickel RE, Hobeika P, Robbins DS. Zickel supracondylar nails for fractures of the distal end of the femur. Clin Orthop 1986 Nov;212:79-88.
14. Butler M, Brumback RJ, Ellison TS, Poka A, Bathon GH, Burgess AR. Interlocking intramedullary nailing for ipsilateral fractures of the femoral shaft and distal part of the femur. J Bone Joint Surg Am 1991 Dec;73:1492-502.
15. Leung KS, Shen WY, So WS, Mui LT, Grosse A. Interlocking intramedullary nailing for supracondylar and intercondylar fractures of the distal part of the femur. J Bone Joint Surg Am 1991 Mar;73:332-40.
16. Seligson D, Kristian Tk. Use of the Wagner apparatus in complicated fractures of the distal femur. J Trauma 1978 Dec;18:795-9.
17. A Saw, CP Lau. Supracondylar nailing for difficult distal femur Fractures. J Orthop Surg 2003 Dec;11(2):141-7.
18. Becher S, Ziran B. Retrograde intramedullary nailing of open femoral shaft fractures: a retrospective case series. J Trauma Acute Care Surg 2012 Mar;72(3):696-8.
19. Anup K, Mehra MM. Retrograde femoral interlocking nail in complex fractures. J Orthop Surg (Hong Kong) 2002 Jun;10(1):17-21.
20. El-Kawy S, Ansara S, Moftah A, Shalaby H, Varughese V. Retrograde femoral nailing in elderly patients with supracondylar fracture femur; is it the answer for a clinical problem? Int Orthop 2007 Feb;31(1):83-6.
21. Neubauer T, Ritter E, Potschka T, Karlbauer A, Wagner M. Retrograde nailing of femoral fractures. Acta Chir Orthop Traumatol Cech 2008 Jun;75(3):158-66.
22. Giddie J, Sawalha S, Parker M. Retrograde nailing for distal femur fractures in the elderly. SICOT J 2015 Dec;1:31.