Prospective Study on Functional Outcome of Retrograde Femoral Nailing in Distal Third Femoral Fractures

Background: Due to the rapid industrialization, modern lifestyle and the fast pace of life, there is a concomitant rise in a road traffic accident that cripples many lives of the general population. The distal 1/3rd femoral fractures constitute 6% of all femoral fractures. These fractures pose a great challenge in management due to the involvement of soft tissue injury, intra-articular extension, and injury to the extensor mechanism. The debates on the choice of implant for distal femoral fractures are on-going among orthopedic surgeons. Controversy still remains regarding the optimum device for distal femur fixation.

Objectives: To evaluate and compare the clinical and the radiological outcomes of distal 1/3rd femoral fractures stabilization using retrograde nailing constructs.

Materials and Methods: After the screening of patients, a total of 113 cases, who were enrolled in the study, were subjected for surgical management of distal 1/3rd femur fractures with retrograde femoral nailing. All the patients were followed up clinically and radiologically at the immediate post-op period and at the end of 1, 3, 6, 12 and 18 months. The efficacy and functional outcome of distal femoral retrograded nailing were charted according to Lysholm knee scores. All cases were followed up for complications and were treated accordingly.

Results: In our study, 113 cases underwent surgical management with distal femoral retrograde nailing. The results were analyzed according to Lysholm’s knee scoring showed excellent in 55 cases (48.67%), good in 39 cases (34.51%), fair in 11 cases (9.73%) and poor in 8 cases (7.07%). The correlation analysis with Pearson’s correlation coefficient (r) was 0.8 which show a highly positive correlation between the union of distal femoral fracture and retrograde distal femoral nailing.

Conclusion: Retrograde distal femoral nailing for AO/ASIF type A and type C distal femoral fractures are a proven and reliable method of fixation. This safe, successful, effective, reliable and useful technique should find a place in the armamentarium of every orthopedic surgeon dealing with distal femoral fractures that initially requires attention to details of the technique to prevent complication and to improve the functional quality of life.


Prasanna Anaberu, Madhan Jeyaraman*, Kartavya Chaudhari, Ajay SS, Sabarish K and Preethi Selvaraj

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