Retrograde intramedullary osteosynthesis of femoral fracture: preliminary results of Maggiore Hospital.

ABSTRACT

The Distal Femoral Nail (DFN), Mathys Medical Ltd. Switzerland) was used in our division for the treatment of fractures of the distal metaepiphysis, and in some cases of the diaphysis, of the femur. A total of 16 cases treated over 30 months, between October 2000 and March 2003 (minimum 6, maximum 61 months), were analyzed retrospectively. A total of 11 metaepiphyseal fractures (65%) and 6 diaphyseal fractures (35%) were treated. Consolidation of the fracture was observed in 15 cases out of 16 (equal to 93.8%) with a mean time of 140 days (minimum 120 days, maximum 240 days) after surgery. Mean flexion of the knee equal to 90 degrees and 3 cases of stiffness with lower mobility at 45 degrees were observed in 2 cases stiffness was of extra-articular origin caused by exuberant bone callus. There were no iatrogenic complications of the vascular type, nor were there infections, or cases of implant loosening. Shortening (1 cm) in a type B2 fracture (based on the AO classification) was observed. The results we obtained suggest that DFN represents a valid alternative to the open treatment of fractures of the distal metaphysis of the femur; in cases of patients with multiple trauma or in elderly patients where invasiveness is reduced, importance is awarded to less blood loss, a shorter amount of time required for surgery, and early mobilization and weight-bearing.