Abstract: Aim: To assess functional and radiological outcome of retrograde IMIL nailing for distal femur fracture
Background: Distal femur fractures pose challenges in Orthopaedic treatment, affecting both young and elderly patients. Retrograde intramedullary nailing has emerged as a preferred technique due to its minimally invasive approach and preservation of soft tissue. This study aimed to evaluate the effectiveness of retrograde intramedullary nailing in distal femur fractures and its impact on surgical technique, outcomes, complications, and union rates. Findings will enhance fracture management and inform treatment decisions for orthopedic surgeons.
Materials and Methods: A prospective study was conducted on 28 patients with distal femur fractures who underwent retrograde intramedullary interlocking nailing. Patient selection criteria included age between 18 and 80 years and the presence of simple and complex supracondylar femur fractures. Exclusion criteria comprised severe osteoarthritis of the knee, associated patella fractures, and certain fracture types. Detailed preoperative examinations and imaging were performed, and the surgical procedure involved retrograde nail insertion, fracture reduction, and fixation. Postoperative rehabilitation and follow-up visits were conducted to assess functional outcomes and complications.
Results: Among the 28 patients treated with retrograde intramedullary nailing, the average union time was 10.5 weeks. The surgery duration ranged from 70 to 180 minutes, with an average of 89.64 minutes. The average blood loss was 224.29 ml. Knee range of motion varied from 0 to 81 degrees, with an average American Knee Society Score of 70.36%. Complications included knee pain (14.3%), knee stiffness (7.1%), shortening (14.3%), and infection (7.1%). The majority of patients achieved good outcomes, with 57.2% experiencing no complications. Shortening less than 1 cm was observed in 8 cases, while shortening of 2 cm or more was recorded in 4 cases.
Conclusion: Retrograde intramedullary nailing demonstrated favourable outcomes in the treatment of distal femur fractures. The procedure offered advantages such as shorter operating times and reduced blood loss compared to other methods. Fracture union occurred within a reasonable time frame, and complications were relatively low. However, careful attention should be given to nail insertion depth and adequate proximal locking. Retrograde nailing is considered a reliable alternative for the treatment of extra-articular distal femur fractures, providing successful osseous healing, and facilitating early mobilization.
