A prospective study on the functional outcome of retrograde intramedullary nailing in AO type 33a fractures of distal femur

Background: Fractures of distal femur are those occurring within approximately 15 cm from the distal articular surface of the femur. Incidence of these fractures have reported to be 8.7/100,000/year. They are complex fractures that are difficult to manage and have potential long term complications if not treated properly like non union, knee stiffness, loss of range of motion, varus collapse and infection. Optimal method of treatment is still disputed. There are many surgical fixation options are available nowadays. Retrograde femoral nailing has been advocated for better functional outcome. Objective: To analyse the functional outcome of retrograde intramedullary nailing in AO type 33A1,33A2 and 33A3 fractures of distal femur in terms of scores according to Neer’s criteria. Method: 12 Patients of either sex diagnosed with distal femoral fractures, AO type A are admitted in a tertiary care referral and teaching institution. All patients were managed with CRIF with retrograde femoral nail (DFN). Patients were followed up for 12-20 months and follow up data such as range of movements and complications were noted. Results: functional outcome was assessed using Neer’s scoring system. 75% of patients had excellent or satisfactory functional results. The average knee range of movement was 91 degree (range: 50-125 degree) and average time to union was 15 weeks (Range: 12-20 weeks). Conclusion: Patients who underwent retrograde femoral nailing showed significant functional & radiological outcomes at 6 months’ follow-up. Retrograde nailing is a good fixation system for fractures of distal femur with better outcome in terms of Range of movements, Early mobilization, Knee stiffness, Less operative time and less blood loss.