A comparative study of the outcomes of fixation of fractures of distal femoral nailing versus plating
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252642Keywords:
Distal, Femur, Fracture, Locking compression plate, Intramedullary nailing, Supracondylar nailing, Non-union, Malunion, Retrograde nail, InfectionAbstract
Background: Distal femur fractures have been historically very difficult to treat as they are often comminuted, unstable, more common in elderly or patients having multiple injuries. Hence, we conducted this study to assess the feasibility and the functional outcome of 30 cases of supracondylar fractures of femur, treated with locking compression plates and retrograde intramedullary supracondylar nails.
Methods: All patients of distal femoral fractures were admitted and history was elicited to reveal the mechanism of the injury and the severity of the trauma, site of the incident, circumstances about which the injury occurred, premorbid medical history and preinjury functional status. Post-operatively patients were discharged with advice to continue physiotherapy as advised and to come for follow up after 3 weeks and later 3 months, 6 months,18 months and 24 months.
Results: Among the 30 cases of supracondylar fracture fixed by supracondylar nail 14 had good scores and one was scored as excellent, whereas those fixed by locking compression plate 14 were scored as good and 1 case was scored as fair. There were no intances of surgical wound infections during the immediate postoperative period.
Conclusions: From the observations and results of our study, it can be concluded that the supracondylar nail is more ideal when compared to the distal femoral locking compression plate as it has less operative time, less blood loss, more range of movement, less soft tissue stripping and faster radiological union when compared to the distal femoral locking compression plate.
Metrics
References
Whittle AP, Wood II GW. Campbell’s operative orthopedics. Fractures of Lower Extremity. J Bone Joint Surg. 2003;85(7):1414.
O’ Brien PJ, Meek RN, Blachut PA, Broekhuyse HM. Fractures of the distal femur: Rockwood and Green’s Fractures in Adults. Lippincott Williams and Wilkins. 2001;2:5.
Seifert, J, Stengal D, Matthes G, Hinz P, Ekkernkamp A, Ostermann, PAW, et al. Retrograde Fixation of Distal Femoral Fractures: Results Using a New Nail System. J Orthop Trauma. 2003;17(7):488-95. DOI: https://doi.org/10.1097/00005131-200308000-00003
Stewart MJ, Sisk TD, Wallace SL. Fractures of the distal third of the femur. J Bone Joint Surg. 1966;48A:784-807.
Kurahatti A, Prabhu E, Naik S, Arun HS. Distal femur fracture, a comparative study of locking compression plate versus distal femur nail. Int J Orthop Sci. 2019;5(2):793-8. DOI: https://doi.org/10.22271/ortho.2019.v5.i2l.92
Daroch MS, Vashisht D, Sreen S. Management of intra-articular fracture of distal femur with LCP and Lag screws in adults. Int J Res Med Sci. 2017;5(4):1434-8. DOI: https://doi.org/10.18203/2320-6012.ijrms20171241
Jillala SR, Ahmed SMW, Shruthi A, Gajul R, Katikitala A, Rakesh K. A Comparative Study of Supracondylar Nail versus Locking Compression Plate in Distal Femur Fractures. Ann Int Med Dent Res. 2017;3(4):35-41. DOI: https://doi.org/10.21276/aimdr.2017.3.4.OR8
Gellman RE, Paiement GD, Green HD, Coughlin RR. Treatment of supracondylar femoral fractures with a retrograde intramedullary nail. Clin Orthop Relat Res. 1996;(332):90-7.
Lucas SE, Seligson D, Henry SL. Intramedullary supracondylar nailing of femoral fractures: A preliminary report of the GSH Supracondylar Nail. Clin Orthop. 1993;296:200-6. DOI: https://doi.org/10.1097/00003086-199311000-00034
Pascarella R, Bettuzzi C, Bosco G, Leonetti D, Dessi S, Forte P, et al. Results in treatment of distal femur fractures using polyaxial locking plate. Strat Traum Limb Recon. 2014;9:13-8. DOI: https://doi.org/10.1007/s11751-013-0182-7
Virk JS, Garg SK, Gupta P, Jangira V, Singh J, Rana S. Distal Femur Locking Plate: The Answer to All Distal Femoral Fractures. J Clin Diagnost Res. 2016;10(10):1-5. DOI: https://doi.org/10.7860/JCDR/2016/22071.8759
Acharya KN, Rao MR. Retrograde nailing for distal third femoral shaft fractures: a prospective study. J Orthop Surg. 2006;14(3):253-8. DOI: https://doi.org/10.1177/230949900601400305
Stewart MJ, Sisk TD, Wallace SL, Sidney L. Fractures of distal femur a compression method of treatment - A comparison of methods of treatment. J Bone Joint Surg. 1966;48(4):784-807. DOI: https://doi.org/10.2106/00004623-196648040-00011
Gellman RE, Paiement GD, Green HD, Coughlin RR. Treatment of supracondylar femoral fractures with a retrograde intramedullary nail. Clin Orthop Relat Res. 1996;(332):90-7. DOI: https://doi.org/10.1097/00003086-199611000-00012
Christodoulou A, Terzidis I, Ploumis A, Metsovitis S, Koukoulidis A, Toptsis C. Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screw and the retrograde intramedullary nail: a comparative study of the two methods. Arch Orthop Trauma Surg. 2005;125(2):73-9. DOI: https://doi.org/10.1007/s00402-004-0771-5
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;76:290-4. DOI: https://doi.org/10.1111/j.1445-2197.2006.03714.x
Koval KJ, Kummer FJ, Bharam S, Chen D, Halder S. Distal femoral fixation: A laboratory comparison of the 95 degree plate, antegrade and retrograde inserted reamed intramedullary nails. J Orthop Trauma. 1996;10:378-82. DOI: https://doi.org/10.1097/00005131-199608000-00003
Duffy P, Trask K, Hennigar A, Barron L, Leighton RK, Dunbar MJ. Assessment of fragment micromotion in distal femur fracture fixation with RSA. Clin Orthop Relat Res. 2006;448:105-13. DOI: https://doi.org/10.1097/01.blo.0000224008.19798.91
Downloads
Published
How to Cite
Issue
Section
