Comparison of Outcome with RNVL Compressive Plating in the Treatment of Extra Articular Supracondylar Femur Fractures

Objective: To compare outcome of retrograde nailing versus locked compressive plating in the treatment of extra articular supracondylar femur fractures. Study Design: A randomized prospective trial. Place and Duration of the Study: Department of Orthopedic Surgery, Ghurki Hospital, Lahore, Pakistan from January 2020 to November 2021. Methodology: A total of 160 (80 in each group) patients aged between 18 to 50 years of both genders with extra articular supracondylar femur fractures were randomized into either retrograde nailing group (Group-A) or locked compressive plating (Group-B). Surgery time and functional outcome were compared in both groups. Demographic characteristics along with mean surgery time and functional outcomes were compared between both study groups. Results: In a total of 160 patients, mean age was 33.57±9.45 years. The mean age in Group-A was 33.24±8.61 years and in Group-B 33.90±10.26 years. In group-A, there were 49 (61.25%) male and 31 (38.75%) female cases while in group-B there were 56 (70%) male and 24 (30%) female cases. The mean surgery time in group-A was significantly less as compared to group-B (83.29±7.48 minutes vs. 106.62 ± 7.69 minutes, p<0.01). The frequency of excellent to good outcome was statistically higher in Group-A as compared to Group-B (p< 0.05). Conclusion: Retrograde nailing gave better results in the treatment of extra articular supracondylar femur fractures when compared with locked compressive plating. Retrograde nailing can be opted to reduce the surgery time and gain better functional outcome. Keywords: Femur fracture, nailing, plating, surgery time, functional outcome

Outcome of Retrograde Nailing in the Treatment of Extra Articular Supracondylar Femur Fractures

Objective: To find out outcome of retrograde nailing in the treatment of extra articular supracondylar femur fractures. Study Design: A prospective observational study. Place and Duration of the Study: The Department of Orthopedic Surgery, Ghurki Hospital, Lahore, Pakistan from January 2020 to August 2021. Methodology: A total of 92 patients of both genders aged 18 to 50 years with supracondylar femur fractures and supracondylar fractures with fracture line extending to distal third of femoral shaft were enrolled. Retrograde nailing was performed among all patients. Surgery time and functional outcome were noted. All surgeries were accomplished under spinal/epidural or general anaesthesia. Results: Out of a total of 92 patients, there were 59 (64.1%) were male and 33 (35.9%) female. Overall, the mean age of patients was 33.12±9.08 years. The mean surgery time was noted to be 85.29±7.48 minutes. A total of 85 patients completed the designated period of 12-weeks for the evaluation of functional outcome. Excellent outcomes were observed in 47 (55.3%) cases, good 25 (29.4%), fair 9 (10.6%) and poor in 4 (4.7%) cases. Excellent to good outcomes were observed in 72 (84.7%) cases. Conclusion: Retrograde nailing had good outcomes in the treatment of extra articular supracondylar femur fractures. Keywords: Femur fracture, nailing, surgery time, functional outcome.

TO EVALUATE THE FUNCTIONAL OUTCOME OF LOCKING COMPRESSION PLATE FOR FRACTURES AROUND KNEE JOINT(DISTAL 1/3RD FEMUR OR PROXIMAL 1/3RD TIBIA)

Background: To evaluate the functional outcome of locking compression plate for fractures around knee joint (Distal 1/3rd femur or proximal 1/3rd tibia) Methods: This prospective functional out-come study has been conducted on This prospective study has been conducted on 50 patients with Distal 1/3rd femur and 50 patients with proximal 1/3rd tibia Results: According to Modified Mehrotra’s Criteria, the excellent (44.00%) and fair (42.00%) and (14.00%) had poor result Conclusion: Locking compression plate is the optimal tool for many supracondylar fractures of femur and proximal tibia fractures. It provides rigid fixation, where a widening canal, thin cortices and frequently poor bone stock make fixation difficult. Keywords: Femur, Tibia, Locking plate, MIPO, Outcome.

Use of Tantalum Trabecular Metal Cones for Management of Nonunion of the Distal Femur with Segmental Bone Defects: Technique and Case Series

Introduction: Segmental bone loss in the distal femur presents a challenge for reconstruction regardless of etiology. Use of tantalum trabecular metal cones with intramedullary fixation and autologous bone graft may be used as a salvage technique in difficult situations where other options have either been exhausted or are unavailable. Case Report: Surgical planning and technique for this approach to reconstruction are described. A retrospective review of five cases with >1 year of follow-up was performed to provide radiographic and clinical outcomes. All five patients had satisfactory outcomes with clinical union and retention of implants at final follow-up (average >4 years). Conclusions: Use of tantalum metal cones for reconstruction of distal femur nonunion with segmental bone defects can be a successful technique in a complex group of patients. Keywords: Femur, bone defect, non-union, induced membrane, tantalum.