Analytic study of functional outcome of retrograde intramedullary nailing for distal femoral fractures in adults


  • Srujith Kommera Department of Orthopaedics, Shadhan institute of medical sciences, Hyderabad, Telangana, India
  • Pradeep Reddy Department of Orthopaedics, Shadhan institute of medical sciences, Hyderabad, Telangana, India
  • Saba Khaleel Department of Orthopaedics, Shadhan institute of medical sciences, Hyderabad, Telangana, India



Retrograde nailing, Distal femur fractures, Supracondylar approach, Mullers classification, Union, Functional outcome


Background: The purpose of this Study was to evaluate the clinical and functional outcome of retrograde intramedullary nailing for distal femur fractures.

Methods: This 2 years observational study was done between December 2018 to January 2021, 60 patients with distal femoral fractures were surgically treated at our hospital using retrograde intramedullary nail. The patient was placed supine on fracture table with affected limb flexed to 60 degrees. Through a Transpatellar approach, the nail was introduced in retrograde method after serial reaming. Postoperatively knee range of motion was started immediately and weight bearing was progressed after signs of fracture union were noted on x-rays. The outcome was evaluated for time taken for fracture union, complications and functional outcome with various types of fractures.

Results: All the fractures in the present study healed at an average of 13 weeks. However 25 to 40% of these patients underwent bone grafting primarily with reports of delayed union and non-union. Shortening occurred in two patients (3.33%) did affect the final functional outcome. average range of motion is 120 deg. for all fractures, 119 deg. for extra-articular fractures and 118 deg. for intra-articular fractures. Infection rates are low (0% to 8%).

Conclusions: The study shows distal femoral fractures were common due to high velocity injuries, retrograde nailing is an excellent technique for management of distal femoral fractures as it promotes high rate of fracture union with less complications.


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Original Research Articles