Retrograde Intramedullary Nailing for the Fixation of Distal Femoral Fractures

Introduction: Retrograde intramedullary nailing (RIN) is one of the most preferable surgical method for distal femoral fractures. In this study, we aim to evaluate the clinical and radiological outcomes of applying RIN method in distal femoral fractures.
Methods: In this retrospective study, 27 patients treated with RIN surgical method for distal femoral fractures were evaluated. The fractures were assessed according to AO classification, and Gustilo-Anderson classification was used for the open fractures. We have utilized the mini-arthrotomy approach. Modified Knee Rating Scale of the Hospital for Special Surgery (HSS) was used to evaluate the clinical and functional outcomes of the patients at the latest follow-up. The radiological assessment of the patients was done from consecutive direct X-rays, and the radiological union times were recorded.
Results: The mean follow-up period was 19.26±8.59 months (range, 7–40 months). The mean union time was calculated as 26.47±5.34 weeks (range, 21–72 weeks). One patient had delayed union (10 months). The mean knee joint range of motion was measured as 102.29°±15.70° (range 60°–135°). This was calculated as 105.60°±13.51° in type A and as 95.67°±15.70° in type C fractures. In total, there were six (31.6) excellent, ten (52.6%) good, two (10.5%) fair, and one (5.3%) bad result.
Discussion and Conclusion: Owing to its safety and reliability, RIN was considered as a safe and effective surgical technique in the management of distal femoral fractures and was applicable in all fractures except for Gustilo-Anderson types 3B and C.

Keywords: Distal femur fractures; Fracture fixation; Retrograde intramedullary nailing