Retrograde intramedullary nailing of comminuted intra-articular distal femur fractures results in high union rate

Abstract Objective The purpose of this prospective study was to introduce the application of a double reverse traction repositor (DRTR) in the retrograde intramedullary nailing (RE-IMN) of AO/OTA 33A distal femur fractures. Patients and methods A total of 27 patients with AO/OTA type 33A distal femur fractures who were admitted from January 2015 to May 2017 to a level I trauma center of a tertiary university hospital were enrolled in this prospective study. A DRTR was used to facilitate RE-IMN for the reduction of distal femur fractures in all patients. The demographic and fracture characteristics, surgical data, postoperative complications, and prognostic indicators of 24 patients were recorded. Results The DRTR helped achieve and maintain the reduction of all distal femur fractures in the present study. All surgeries were conducted by closed reduction, and excellent alignment was observed in the postoperative X-ray images. In the present study, 18 males and 6 females were included, and the average age of all patients was 51.3 years (range, 24–68 years). The mean operation time, intraoperative blood loss, intraoperative fluoroscopy time, and length of postoperative hospital stay were 137 min (range from 80 to 210 min), 320 ml (range from 200 to 600 ml), 28 (from 24 to 33), and 9 days (from 5 to 14 days), respectively. Eleven patients were found to have postoperative deep venous thrombosis before discharge. No cases of wound infection were observed. No cases of nonunion or malunion were observed. The average follow-up duration was 21 months (18–30 months). The average HHS, LKFS, and VAS scores at the 1-year follow-up were 89.9 (86–97), 79.1 (75–87), and 2.1 (from 0 to 5). No complications associated with DRTR were found. Conclusions A DRTR can be successfully applied in the treatment of distal femur fractures with RE-IMN, and it can not only help achieve or maintain the reduction of distal femur fractures with closed methods but also promote fixation with RE-IMN.

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Stable Fixation and Immediate Weight-Bearing After Combined Retrograde Intramedullary Nailing and Open Reduction Internal Fixation of Noncomminuted Distal Interprosthetic Femur Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001154 ◽

2018 ◽

Vol 32 (6) ◽

pp. e237-e240 ◽

Cited By ~ 9

Author(s):

Mohammed S. Hussain ◽

Steven K. Dailey ◽

Frank R. Avilucea

Keyword(s):

Internal Fixation ◽

Intramedullary Nailing ◽

Open Reduction ◽

Weight Bearing ◽

Open Reduction Internal Fixation ◽

Stable Fixation ◽

Retrograde Intramedullary Nailing ◽

Femur Fractures

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Nail–Plate Constructs for Periprosthetic Distal Femur Fractures

The Journal of Knee Surgery ◽

10.1055/s-0039-1683444 ◽

2019 ◽

Vol 32 (05) ◽

pp. 403-406 ◽

Cited By ~ 1

Author(s):

Gudrun Mirick Mueller

Keyword(s):

Intramedullary Nailing ◽

Distal Femur ◽

Nail Plate ◽

Early Mobilization ◽

Primary Treatment ◽

Locked Plating ◽

Treatment Methods ◽

The Past ◽

Hybrid Stabilization ◽

Femur Fractures

AbstractOver the past several years, the nail–plate construct (NPC) has emerged as a novel construct for the treatment of challenging distal femoral periprosthetic fractures. This construct, which uses a combination of the two primary treatment methods—lateral locked plating and retrograde intramedullary nailing, creates hybrid stabilization and allows the potential for early mobilization. This article will give the rationale for the use of the NPC as well as a review of the current published literature reviewing its use.

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