Syed Imaduddin, Tayeb Asim, Muhammad Asif Memon.
Surgical outcome of supracondylar femoral fractures treated with Retrograde Supracondylar nailing.
Pak J Surg Jan ;30(1):30-5.

Introduction: Supracondylar fracture of femur is common both in elderly with osteoporotic bones and in young patients aft er motor vehicle accidents. Treatment of these fractures is a challenging task for most orthopaedic surgeons. Th is study evaluated the surgical outcome of distal femoral fractures treated with retrograde supracondylar nailing. Methodology: Th is study was carried out in the department of Orthopaedic surgery, Dr. Ziauddin Hospital Karachi. Th e surgical outcome of 42 patients who were treated with retrograde supracondylar intramedullary nailing for distal femur fractures between February 2007 and February 2011 were evaluated. All patients were assessed with regards to operative time, blood loss, shortening, angular deformity, knee range of motion, extensor lag at knee joint, initiation of weight bearing and duration of union. Patients were followed-up both clinically and radiologically every 6 weeks for a mean duration of 20 (12 – 24) months. Results: Th e mode of injury was motor vehicle accident in 25 (60%), gunshot injury in 3 (7%) and fall in 14 (33%) cases. 34 (81%) fractures were closed and 8 (10%) fractures were compound. Average operation time was 2 hours and average blood loss was 300 ml. Th ere were no cases of non-union; the mean union time was 5.6 months (5 – 7 months). Th ere was no case of infection. No angular deformity or shortening was observed postoperatively. Knee fl exion of more than 1200 was achieved in 33 patients, 1100 in 8 patients and 1000 in 1 patient. 3 patients had anterior knee pain of transient nature which subsided within one year aft er rehabilitation, full weight bearing and self exercises. By the end of one year overall outcome based on Schatzker and Lambert criteria was excellent in 31 patients (74%), good in 7 patients (16%) and fair in 4 (10%) patients. Conclusion: Retrograde supracondylar femoral nailing for AO/ASIF type A and type C distal femur (supracondylar) fractures is a proven and reliable method of fixation. It also provides excellent results in selected comminuted fractures of the distal femur with a low complication rate.

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