Outcome of Retrograde Multidirectional Interlocking Intramedullary Nailing for Distal Third Femur Shaft Fracture

Abstract

Aims: To study the outcome of retrograde intramedullary nailing for distal third femur shaft fracture in adult patients. Study Design: A case series study. Place and Duration of Study: Department/Casualty of Orthopaedics at Government Medical College, Amritsar between November 2018 to December 2020. Material and Methods: The study included a total of 30 cases of either sex adult patients with a mean of 44.33 years having closed type A distal third femur shaft fracture admitted in Department of Orthopaedics at Government Medical College, Amritsar treated with retrograde multidirectional intramedullary interlocking nail. Results: Mean duration of surgery was 90.50 minutes(min- 80 minutes, max-104 minutes). Weight bearing was started on the 3rd day for 60% of the patients. Mean union time was 18.62 weeks (Min – 13 weeks; Max.- 26 weeks). In 56.67% (17 patients), the knee flexion was (111 to 120) degrees. Mean knee flexion of the patients was 113.23° (Min- 104 degrees; Max- 125 degrees). Excellent to good results were seen in 80%(24 patients) while fair to poor results were seen in 20% (6 patients). There were no cases with evidence of deep infection. Conclusions: Retrograde multidirectional nailing is a good option in the management of distal femoral fractures (especially type A fractures) due to less invasive procedure and hence lesser blood loss and infection, short operative time and exposure to c-arm radiations. It also provides early mobilization and weight bearing with low overall complications like knee stiffness, and good anatomical and functional outcome with faster rates of union.