Retrograde intramedullary nailing of comminuted intra-articular distal femur fractures results in high union rate.
Eur J Orthop Surg Traumatol
; 32(8): 1577-1582, 2022 Dec.
Article
in En
| MEDLINE
| ID: mdl-34623470
ABSTRACT
PURPOSE:
Retrograde intramedullary nailing of intra-articular distal femur fractures with metaphyseal and/or epiphyseal comminution is controversial and considered a contraindication to nailing. The purpose of this study was to report union rate, complications, and secondary procedures after open reduction and retrograde intramedullary nailing of comminuted, intra-articular, distal femur fractures. MATERIALS ANDMETHODS:
A retrospective review performed at an urban level one trauma center identified 16 patients AO/Orthopedic Trauma Association (OTA) 33-C2 and 33-C3 femur fractures treated with open reduction, lag screws, and retrograde intramedullary nail fixation. Radiographic union, complications, secondary operations were reviewed.RESULTS:
At the 3-month follow-up 12 (86%) of the 14 patients with radiographs had healed. At last follow-up, all 16 femur fractures achieved radiographic union after the index procedure. No patient required a revision procedure for delayed union or nonunion. Complications occurred in 6 (38%) patients, including failed distal interlocking screws (n = 2), knee arthrofibrosis (n = 3), superficial wound infection (n = 1), and wound dehiscence (n = 1). Three (19%) patients required secondary procedures, which included knee manipulation under anesthesia (n = 3), distal interlocking screw removal (n = 2), and closure of a wound dehiscence (n = 1).CONCLUSIONS:
Comminuted intra-articular distal femur fractures that can be successfully treated with retrograde IMN fixation will reliably go on to union with a complication rate that is favorable to that reported for plate fixation. LEVEL OF EVIDENCE Level IV, retrospective case-series.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Fractures, Comminuted
/
Femoral Fractures
/
Fracture Fixation, Intramedullary
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Eur J Orthop Surg Traumatol
Year:
2022
Document type:
Article
Affiliation country:
United States