Abstract

Background: Fractures of distal femur are complexand nearly all of times a tailored approach is required for these fractures. Over a phase of time variety of approaches and implants have been used for these fractures. The use of retrograde femur nail for fixing femur fracture, by means of entry from inter-condylar notch of femur, is a recognized technique of treatment, but the majority surgeons are concerned of making an entry from the knee joint because of possible complications like knee pain, arthro-fibrosis, infections etc. The aim of this study was to look into its effectiveness in fixation of distal 1/3rd fracture of femur with particular emphasis on the outcome and inherent surgical challenges.

Methods: A prospective study of 45 patients with fracture femur distal one third were treated by retrograde nailing, from Aug 2018 to Aug 2020, after obtaining necessary approval from the Institutional ethical & research committee. All the patients were followed till fracture union and evaluated on the basis of demography, length of healing, complications, and surgical challenges.

Results: We observed that mean age of patients was 46.5 years (18 years to 75 years) where 75% were male and 25% were female. Average duration of healing was 24 weeks (ranging from 10 weeks to 40 weeks) with 100% healing achieved. Mean knee range of motion was 124-degree, rate of knee pain 10%, re-operation rate 2.2%, infection rate 2.2%.

Conclusion: Retrograde femoral nailing is a dependable option to antegrade nailing or plate fixation for diaphyseal fracture distal one third femur, and might be even advantageous when antegrade nail entry is challenging like ipsilateral hip fractures, previous implant in hip & proximal femur, ipsilateral pelvi-acetabular injury, bilateral femoral shaft fracture, floating Knee injuries, poly-trauma and obese patients

Keywords: Distal femur fractures; Retrograde femoral nailing; Supracondylar nail