Evaluation of functional outcome of distal femur fractures treated by closed reduction and internal fixation with retrograde femoral nail

Abstract

Introduction: ‘Distal femoral fractures’ are defined as fractures up to 15 cms from distal femoral articular surface. Their traditional management comprised of skeletal traction, closed manipulation of fracture and external immobilization in the form of casts and cast bracings. These led to various complications. The trend of open reduction and internal fixation has become evident in the recent years, with a variety of implant options. This study aims to evaluate the functional outcome of 35 adult distal femur fractures treated with closed reduction and internal fixation with retrograde femoral nail. Materials and methods: 35 adults with distal femur fractures without neurovascular injury were considered for this study. After fixation, they were evaluated in regular follow-ups for functional outcome using Neer’s score and radiological union. Results: In our study, the average time for radiological union was 16.89 weeks. There were 3 patients with superficial infection. There were no varus collapse or implant failure. Functionally, 21 (60%) patients had excellent, 12 (34.29%) patients had good and 2 patients (5.71%) had fair results. There were no poor results. Conclusion: With the present study, we concluded that retrograde intramedullary supracondylar nail is a very good fixation system for distal third femoral fractures, particularly in extra-articular type fractures, due to minimal soft tissue dissection, preservation of fracture hematoma, reduced hospital stays, reduced infection rates and early mobilization.