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Outcome of Fracture Distal Femur Treated with Retrograde Nailing
Keywords:
Distal femur fracture, Retrograde interlocking nail, Schatzker and Lambert criteria.Abstract
Objective: To determine the functional and radiological outcome of fracture distal femur treated with retrograde interlocking nail.
Methods: This was a descriptive study conducted at Department of Orthopaedics surgery Jinnah Post Graduate Medical Centre(JPMC) from 15th February 2016 to 10th January 2019.All patients fulfilling the inclusion criteria were treated with retrograde nailing. Post operative functional outcome was evaluated with Schatzker and Lambert criteria as graded as excellent, good and poor. Radiologically union was assessed with x rays.
Results: There were 97 patients with mean age of 35.20±10.66(range 20 to 50 years) of age. Male patients were 74(76.2%) and female 23(23.7%). Majority(70.1%,n=68) of fractures were due to motor vehicle accidents. Right side fracture was present in 60(61.9%) patients and left in 37(38.1%). Excellent outcome was noted in 72(74.2%) patients and good in 25(25.7%).No non union was documented.
Conclusion: Excellent and good functional and radiological outcome was achieved in distal femur patients treated with retrograde interlocking nailing. We recommend retrograde interlocking nail as an implant of first choice for selected distal femur fractures.
References
1. Rathi NB, Solanki RA, Patel HA, Tank PJ. Study of Retrograde Intramedullary Nailing In Distal One Third Shaft Femur Fracture. Journal of Dental and Medical Sciences. 2016;15(4):18-23.
2. Sidhu AS, Mann HS, Gurusukhman S, Bassi A, Banga A. Management of distal fracture femur-
3. Saw A, Lau CP. Supracondylar nailing for difficult distal femur fractures. J OrthopSurg.2003; 11(20): 141-147.
4. Arneson TJ, Melton LJ, Lewallen DG, O Fallen WM . Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. Clin Orthop Relat Res.1988; 234:188-194.
5. Helfet DL. Retrograde intramedullary nail of supracondylar fractures of femur. Clin Orthop Relat Res. 1998; 350: 80-84.
6. Khare A, Mehra M. Retrograde femoral interlocking nail in complex fractures. J Orthop Surg. 2002; 10(1): 17-21. 7. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10): 1-133.
8. Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979, (138): 77-83.
9. Cass J, Sems A. Operative versus non operative management of distal femur fracture in myelopathic non ambulatory patients. Orthopaedics. 2008; 31(11):1-4.
10. Seifert J, Stengal D, Matthes G, Hinz P, Ekkernkamp A, Ostermann PA, et al. Retrograde fixation of distal femoral fractures: Results Using a New Nail System. J Orthop Trauma. 2003; 17(7): 488-495.
11. Crist B, Rocca GD, Murtha YM. Treatment of acute distal femur fractures. J Orthop Trauma. 2008; 31(7): 1-10.
12. Acharya KN, Rao MR. Retrograde nailing for distal third femoral shaft fractures: A prospective study. J Orthop Surg (Hong Kong). 2006;14:253-8.
13. Gupta SKV, Govindappa CVS, Yalamanchili RK. Outcome of retrograde intramedullary nailing and locking compression plating of distal femoral fractures in adults. OA Orthopedics. 2013; 1(3): 23. 14. Neubauer T, Ritter E, Potschka T, Karlbauer A, Wagner M. Retrograde nailing of femoral fractures Acta Chir Orthop Traumatol Cech. 2008;75:158-66.
15. Kim JW, Oh CW, Kyung HS, Min WK ,Yoon SH. Factors Affecting the Results of Distal Femoral Fractures Treated by Retrograde Intramedullary
Nailing. Chinese Journal of Reparative and Reconstructive Surgery.2009;23(11):1311-1315.
16. Christodoulou A, Terzidis I, Ploumis A, Metsovitis S, Koukoulidis A, Toptsis C. Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screwand the retrograde intramedullary nail: A comparative study of the two methods. Arch Orthop Trauma Surg. 2005; 125(2): 73-79.
17. Papadokostakis G, Papakostidis C, Dimitriou R,Giannoudis PV. The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: A systematic review of the literature. Injury. 2005;36(7):813-822. 18. 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;31:83-6.
19. Walcher F, Frank J, Marzi I. Retrograde nailing of distal femoral fracture-clear and potential indications. Eur J Trauma. 2000;26:155-68.
20. Henderson CE, Lujan T, Bottlang M, Fitzpatrick DC, Madey SM, Marsh JL. Stabilization of distal femur fractures with intramedullary nails and locking plates: Differences in callus formation. Lowa Orthop J. 2010;30:61-8.
21. Kumar A, Jasani V, Butt MS. Management of distal femoral fractures in elderly patients using retrograde titanium supracondylar nails. Injury. 2000;31(3):169-73. 22. Kregor PJ, Obremskey WT. Long-term functional outcomes after intra-articular distal femur fractures: ORIF versus retrograde intramedullary nailing. Orthopedics. 2008;31(8):748-50.
23. Hartin NL, Harris I, Hazratwala K. Retrograde nailing versus fixed-angle blade plating for supracondylar femoral fractures: a randomized controlled trial. ANZ J Surg. 2006;76(5):290-4. 24. Habib MK, Niazi A. Outcome of Retrograde Interlocking Nail in Supracondylar Femur Fracture.J Pak Ortho Association. 2018;30(1):5-8.
25. Shafiq M, Akram R, Ahmed A, Kaleem ullah, Ahmad I, Atiq uz Zaman et al. Retrograde femur nail; Outcome of retrograde femur nail, is it implant of choice for distal shaft of femur fracture? Professional Med J. 2018; 25(3):364-370.
2. Sidhu AS, Mann HS, Gurusukhman S, Bassi A, Banga A. Management of distal fracture femur-
3. Saw A, Lau CP. Supracondylar nailing for difficult distal femur fractures. J OrthopSurg.2003; 11(20): 141-147.
4. Arneson TJ, Melton LJ, Lewallen DG, O Fallen WM . Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. Clin Orthop Relat Res.1988; 234:188-194.
5. Helfet DL. Retrograde intramedullary nail of supracondylar fractures of femur. Clin Orthop Relat Res. 1998; 350: 80-84.
6. Khare A, Mehra M. Retrograde femoral interlocking nail in complex fractures. J Orthop Surg. 2002; 10(1): 17-21. 7. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10): 1-133.
8. Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979, (138): 77-83.
9. Cass J, Sems A. Operative versus non operative management of distal femur fracture in myelopathic non ambulatory patients. Orthopaedics. 2008; 31(11):1-4.
10. Seifert J, Stengal D, Matthes G, Hinz P, Ekkernkamp A, Ostermann PA, et al. Retrograde fixation of distal femoral fractures: Results Using a New Nail System. J Orthop Trauma. 2003; 17(7): 488-495.
11. Crist B, Rocca GD, Murtha YM. Treatment of acute distal femur fractures. J Orthop Trauma. 2008; 31(7): 1-10.
12. Acharya KN, Rao MR. Retrograde nailing for distal third femoral shaft fractures: A prospective study. J Orthop Surg (Hong Kong). 2006;14:253-8.
13. Gupta SKV, Govindappa CVS, Yalamanchili RK. Outcome of retrograde intramedullary nailing and locking compression plating of distal femoral fractures in adults. OA Orthopedics. 2013; 1(3): 23. 14. Neubauer T, Ritter E, Potschka T, Karlbauer A, Wagner M. Retrograde nailing of femoral fractures Acta Chir Orthop Traumatol Cech. 2008;75:158-66.
15. Kim JW, Oh CW, Kyung HS, Min WK ,Yoon SH. Factors Affecting the Results of Distal Femoral Fractures Treated by Retrograde Intramedullary
Nailing. Chinese Journal of Reparative and Reconstructive Surgery.2009;23(11):1311-1315.
16. Christodoulou A, Terzidis I, Ploumis A, Metsovitis S, Koukoulidis A, Toptsis C. Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screwand the retrograde intramedullary nail: A comparative study of the two methods. Arch Orthop Trauma Surg. 2005; 125(2): 73-79.
17. Papadokostakis G, Papakostidis C, Dimitriou R,Giannoudis PV. The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: A systematic review of the literature. Injury. 2005;36(7):813-822. 18. 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;31:83-6.
19. Walcher F, Frank J, Marzi I. Retrograde nailing of distal femoral fracture-clear and potential indications. Eur J Trauma. 2000;26:155-68.
20. Henderson CE, Lujan T, Bottlang M, Fitzpatrick DC, Madey SM, Marsh JL. Stabilization of distal femur fractures with intramedullary nails and locking plates: Differences in callus formation. Lowa Orthop J. 2010;30:61-8.
21. Kumar A, Jasani V, Butt MS. Management of distal femoral fractures in elderly patients using retrograde titanium supracondylar nails. Injury. 2000;31(3):169-73. 22. Kregor PJ, Obremskey WT. Long-term functional outcomes after intra-articular distal femur fractures: ORIF versus retrograde intramedullary nailing. Orthopedics. 2008;31(8):748-50.
23. Hartin NL, Harris I, Hazratwala K. Retrograde nailing versus fixed-angle blade plating for supracondylar femoral fractures: a randomized controlled trial. ANZ J Surg. 2006;76(5):290-4. 24. Habib MK, Niazi A. Outcome of Retrograde Interlocking Nail in Supracondylar Femur Fracture.J Pak Ortho Association. 2018;30(1):5-8.
25. Shafiq M, Akram R, Ahmed A, Kaleem ullah, Ahmad I, Atiq uz Zaman et al. Retrograde femur nail; Outcome of retrograde femur nail, is it implant of choice for distal shaft of femur fracture? Professional Med J. 2018; 25(3):364-370.
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Published
2020-02-17
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Outcome of Fracture Distal Femur Treated with Retrograde Nailing. (2020). Journal of Pakistan Orthopaedic Association, 31(4), 149-152. https://www.jpoa.org.pk/index.php/upload/article/view/351
