CONSEQUENCES OF RETROGRADE SUPRACONDYLAR NAILING AND LOCKING COMPRESSION PLATES FOR TREATMENT OF DISTAL FEMORAL FRACTURES: A RETROSPECTIVE STUDY

Main Article Content

Suhail Wisal
Muhammad Shuaib Chandio
Fayaz Hussain
Waseem Ahmed
Mushtaque Ahmed Shaikh
Sajid Younus

Keywords

Locked Compression Plate, Retrograde Supracondylar Nail, distal femur fractures

Abstract

Background: Less than 7% of femur shaft fractures have been reported in the literature to involve distal third femoral fractures. The current discourse centers on the management of these fractures, emphasizing two well-known implants: the Locked Compression Plate (LCP) and the Retrograde Supracondylar Nail (RSN). Both of these implants has benefits and drawbacks of its own. Treatments for distal third femoral fractures currently include non-locking plates, pre-shaped locking compression plates, and retrograde supracondylar nails. Our understanding of the biological components of fracture fixation continues to advance.


Objective: To analyze the problems that arise after retrograde supracondylar nailing and locking compression plate treatment for distal femur fractures.


Study design: A retrospective study


Place and Duration:  This study was conducted in Khyber Teaching Hospital Peshawar from August 2022 to August 2023


Methodology: All the patients who were involved in this research were those who were operated on for distal third femur fractures with LCP and RSN during the time period of this research. All of the participants were evaluated with X-rays. The clinical examination of each patient was performed. Skeletal traction was used in our study to immobilize individuals who had suffered injuries. Both surgical consent and pre-operative evaluations were completed. When treating open fractures, external fixation was done first, and within two to three weeks, definitive surgery was planned.


Results: A total of 60 patients were involved in this research. A total of 42 males and 18 females were included in this study. Overall 27 (45%) of the patients were treated with RSN and 33 (55%) of the participants were treated with LCP. A total of 13 patients in the RSN group and 18 patients in the LCP group had complications.


Conclusion: Both plating and nailing have shown benefits in addition to their respective drawbacks. The surgeon should choose the right implant after taking into account the fracture pattern, the patient's physical state, the length of the procedure, and any potential intraoperative difficulties.

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References

1. Rajheiman R, Senthilnathan A, Prabhakar R, Vijaya K. A retrospective analysis of complications following distal femoral fractures treated with retrograde supracondylar nailing and locking compression plate. International Journal of Orthopaedics. 2022;8(1):13-6.
2. Krishna C, Shankar RV. Current concept of management of supracondylar femur fracture: retrograde femoral nail or distal femoral locking plate. International Surgery Journal. 2016 Dec 9;3(3):1356-9.
3. Gill SP, Mittal A, Raj M, Singh P, Singh J, Kumar S. Extra articular supracondylar femur fractures managed with locked distal femoral plate or supracondylar nailing: a comparative outcome study. Journal of Clinical and Diagnostic Research: JCDR. 2017 May;11(5):RC19.
4. Hartin NL, Harris I, Hazratwala K. Retrograde nailing versus fixed‐angle blade plating for supracondylar femoral fractures: a randomized controlled trial. ANZ journal of surgery. 2006 May;76(5):290-4.
5. Munzur R. Surgical Management of Supracondylar Femoral Fracture with Locking Compression Plate.
6. Pushkar D, Bhan N. Comparisonof Results of Distal Femoral Fractures Treated by Internal Fixation with Locking Compression Plate and Retrograde Femoral Nail.
7. Zhang J, Wei Y, Yin W, Shen Y, Cao S. Biomechanical and clinical comparison of single lateral plate and double plating of comminuted supracondylar femoral fractures. Acta Orthop Belg. 2018 Jun 1;84(2):141-8.
8. AHMED U, AHMAD U, ZAHEER M, SADAQAT A, KHALID Z. Comparison of outcome with retrograde nailing versus locked compressive plating in the treatment of extra articular supracondylar femur fractures. Methodology. 2021 Nov.
9. Yogi LK, Mahi G, Lokhande M. Evaluation of short term complications following use of retrograde intramedullary femoral interlocking nail for fractures of distal femur. Int J Orthop. 2020;6(3):149-52.
10. Memon R, Patel D, Patel N. Functional outcomes of retrograde femoral nailing in extra articular distal third femoral fractures. International Journal of Orthopaedics. 2020;6(1):143-6.
11. Halpenny J, Rorabeck CH. Supracondylar fractures of the femur: results of treatment of 61 patients. Can J Surg. 1984;27:606-609.
12. Healy WL, Brooker AF Jr. Distal femoral fractures. Comparison of open and closed methods of treatment. Clin Orthop Relat Res. 1983;174:166-171.
13. Seinsheimer F 3rd. Fractures of the distal femur. Clin Orthop Relat Res. 1980;153:169-179.
14. Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979;138:77-83.
15. Sanders R, Swiontkowski M, Rosen H, et al. Doubleplating of comminuted, unstable fractures of the distal part of the femur. J Bone Joint Surg Am. 1991;73:341- 346.
16. Ricci WM, Loftus T, Cox C, et al. Locked plates combined with minimally invasive insertion technique for the treatment of periprosthetic supracondylar femur fractures above a total knee arthroplasty. J Orthop Trauma. 2006;20:190-196.
17. Kregor PJ, Stannard JA, Zlowodzki M, et al. Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results. J Orthop Trauma. 2004;18:509-520.
18. Son DW, Kim HS, Choi WY. Risk Factors for Knee Stiffness in Distal Femoral Fractures. J Korean Fract Soc. 2018;31(4):123-131.
19. Ehlinger M, Dujardin F, Pidhorz L, Bonnevialle P, Pietu G, Vandenbussche E. SoFCOT: Locked plating for internal fixation of the adult distal femur: influence of the type of construct and hardware on the clinical and radiological outcomes. Orthop Traumatol Surg Res. 2014;100:549-554.
20. Carmack DB, Moed BR, Kingston C, Zmurko M, Watson JT, Richardson M. Identification of optimal intercondylar starting point for retrograde femoral nailing: An anatomical study. J Trauma. 2003;55(4):692-695.