Outcomes of Distal Femur Fractures Treated with Retrograde Indigenous Intramedullary Supracondylar (IMSC) Nailing

Abstract

Nadeem A. Lil, Brij N. Ladani, Vipul R. Makwana and Arjav R. Patel

Introduction Fractures of the distal femur are complex injuries that pose a challenge to orthopaedic surgeon. Significant advances have been made in treatment of these fractures. Out of various options for surgical treatment, retrograde intramedullary nailing has several benefits compared to other methods of fixation. Amongst the routinely available IMSC nails which have a specific design, we used an indigenous IMSC nail with unique design.

Materials And Methodology We conducted a retrospective study among 40 patients with distal femur fractures treated with this indigenous IMSC nail in our institute from May 2019 to October 2021. The patients were followed up in outpatient department till June 2022. Data was retrieved from case record forms and hospital information computer software. The study was conducted after obtaining permission from institutional review board.

Results All the patients in our study were assessed using knee society score and functional knee score. Average knee society score at final follow up was 88.75/100 and average functional knee score at final follow up was 86.50/100 which showed excellent results. The results were better for extra-articular fractures. Average operative time, blood loss, time for radiological union and rate of complications were considerably less.

Discussion Retrograde intramedullary nailing has been developed in order to address previous problems associated with distal femur fracture fixation. It has several advantages over plate fixation. Indigenous IMSC nail used in our study has added benefits over the routine IMSC nail due to its structure, number of screw holes in the distal part of nail, alignment of screw holes inside nail and unique thread design of the screws. Thus, it provides multi-planar fixation of fracture rather than in only one plane as achieved by routine IMSC nail giving excellent rotational stability to bone-implant construct.

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