Type C 1 and 2 Fractures of the Distal Femur Treated with a Retrograde Nail: Knee Recovery at Six Years Follow-Up

Abstract

Purpose: The object of this study was to assess the function of the knee joint and the development of post-traumatic arthritis at a minimum of six years in patients in whom an intra-articular distal femoral fracture had been treated with a reamed retrograde intramedullary nail. Methods: This is a retrospective study of thirty intercondylar-supracondylar femoral fractures treated with a reamed retrograde nailing. According to the OTA classification, there were 19 (63 %) type C 1 fractures and 11 (37 %) type C 2 fractures. The operative technique included reduction of the fracture, minimal internal fixation and the insertion of a retrograde interlocked intramedullary nail. Follow-up ranged from 61 to 84 months (average: 72 months). Functional results were assessed using the Neer score and the radiographic appearance of post-traumatic arthritis using the Ahlback score. Results: Fourteen fractures (46.6 %) achieved an excellent Neer score and only three fractures (10 %) a poor Neer score. No correlation was found between the type of fracture and the final score (p = 0.763). No significant correlation was found between the final Ahlback and Neer scores (p = 0.162). Conclusions: A high percentage of radiographic post-traumatic arthritis should be expected after intra-articular femoral fractures that have been treated with intramedullary nailing. However, because all the objectives of the fracture treatment can be obtained, the functional results remain satisfactory over time.

Key words

supracondylar - fracture - knee - function - nailing

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