Zickel supracondylar nailing for supracondylar femoral fractures in elderly or infirm patients. A review of 33 cases

Abstract

We report 33 cases of femoral supracondylar fracture in elderly or debilitated patients treated by Zickel supracondylar nails. Most of the patients were female and their mean age was 79 years. All had concurrent medical problems and only nine could walk unaided. The operating time averaged one hour and mean blood loss was 100 ml. Postoperative management was by mobilisation in a cast brace or plaster. Six patients died before fracture union; all the others achieved union at an average of 12 weeks. The results were excellent in terms of pain relief, movement and function; there were no infections or nonunions. The locking screws backed out or broke in 26% but this did not prejudice the outcome. Use of the Zickel system is recommended for this group of frail patients.

Retrograde Intramedullary Nailing for Femoral Shaft Fractures in Elderly Patients with Previous Ipsilateral Dynamic Hip Screw Fixation

“…The rate of complications in our study is comparable to that reported for diaphyseal femur fractures in the elderly [18,25,26] . Fortunately, our small cohorts achieved union, both clinically and radiologically, and regained a similar level of function post-operatively.…”

Primary Total Knee Arthroplasty for Simple Distal Femoral Fractures in Elderly Patients with Knee Osteoarthritis

“…In the younger age group, comminuted fractures are usually caused by traffic accidents and are best treated with anatomical reduction and internal fixation2,4). In contrast, distal femoral fractures in elderly patients are often simple fractures and are caused by minor trauma1,2,4).…”

“…Distal femoral fractures in the elderly usually occur as a result of low energy trauma, and are difficult to treat because of osteoporosis and pre-existing osteoarthritis1,2). Traditional methods for internal fixation of distal femoral fractures have included the 95-degree angled blade plate fixation, dynamic condylar screw fixation and retrograde nailing3-7).…”

“…More recently, anatomic locking condylar plates have been developed to treat these fractures8,9). However, poor knee function, prolonged confinement to bed and high mortality rate have been noted even after operative treatment in elderly patients1,2,5,10).…”

A Study on Functional Outcome of Comminuted Supracondylar Fracture Femur Treated by Plating with Fibular Bone Grafting

“…Over the past years, the implants and techniques have improved. It is now recognized by most orthopaedic surgeons the distal femoral fractures are best treated by open reduction and internal fixation [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. The goals in the treatment are the restoration of bone length, anatomic articular surface alignment and rotation, early mobilization of the associated joints rapid fracture union and minimal complications [25][26][27][28].…”