SUPRACONDYLAR FRACTURE FEMUR TREATED WITH INTRAMEDULLARY NAIL: A PROSPECTIVE STUDY

BACKGROUND: Supracondylar fractures are one of the commonest fractures encountered in high velocity trauma which are associated with high morbidity and mortality. 1 Isolated fracture can itself lead to complications such as ARDS and pulmonary embolism(1). This necessitates early stabilization of fractures. Internal fixation is the choice of treatment in supracondylar fractures (AO type-A). 2 Retrograde supracondylar nail has shown to give one of the best results in terms of recovery, fracture union, return to work and the functional outcome. METHODS: 20 patients with supracondylar fracture femur were studied (AO type-A). Supracondylar fractures femur were treated by closed or open reduction and internal fixation by Retrograde supracondylar nail inserted through inter-condylar notch between July 2012 to September 2014 at our institution. The patients were evaluated clinically and radiologically for outcomes. All patients were followed up for an average of 12 months. Outcome was assessed using NEER'S SCORE. 3 RESULTS: Supracondylar femoral extra-articular fractures in 20 patients were treated in this study with retrograde intramedullary supracondylar nail after closed or open reduction. The AO-ASIF fracture classification was used. All extra-articular fractures were selected for study. Six were compound fractures according to the Gustilo-Anderson classification, 4 the fracture was stabilized with the chosen system at an average of 6.9 days post-trauma, with an average operative time of 65. 9 minutes. In 15 cases closed reduction was possible while 5 required open reduction. Post-operatively all patients were shifted to continuous passive mobilization with early toe touch walking and gradually progressive weight bearing with appearance of clinical and radiological signs of union. Evaluation was done according to Neer's rating system. 3 65% excellent results were found. In the present study, road traffic accidents were observed to be the predominant cause of distal third femoral fractures in young patients. All fractures had a sound clinical and radiological union with an average radiological union time of 16.2 weeks and average full weight bearing time was 13.4 weeks. Average knee flexion was 108 degrees with an extensor lag of 4.15 degrees.