Outcomes of Distal 1/3rd Fracture Shaft Femur, Fixed with Retrograde Intra Medulary Nailing: A Short-Term Study

Abstract

The incidence of distal femur fractures is around 37/100,000 patients per year [1]. Characteristically, two separate mechanisms of injury cause distal femur fractures. In the elder population with osteoporotic bone and susceptible soft tissue envelope, distal femoral fractures occur predominately after low energy trauma, e.g., falls and sprain injuries complicated by a high rate of comorbidity (60% female, older than 60 years). In young patients (60% male, younger than 40 years), high energy trauma causes complex injury with comminuted and open fracture pattern. Approx. 30% of patients with distal femur fractures are poly traumatized. 40% had soft tissue injuries, 10% had ligamentous lesions, 8% had meniscal lesions, 10% had dissected cartilage fragments and 15% had patella fractures and 38% of supracondylar/intercondylar distal femoral fractures have a coronal plane fracture [2][3][4][5][6]. Intramedullary femoral nailing has classically been performed using antegrade entry from piriformis fossa and has produced excellent results. Winquist et al had 99.1% union rate with postoperative knee ROM averaging 130degree and 0.9% infection rate [7]. Since antegrade nail has been so successful there has been resistance in surgeons to accept retrograde nailing as an alternative as shown in Figure 1 & 2; [8].Retrograde nailing has a benefit over other techniques, viz