Retrograde nailing and compression bolts in the treatment of type C distal femoral fractures

Abstract

Introduction: This is a prospective study that verifies the usefulness of retrograde intramedullary nailing (IMN) combined with 'independent' compression bolts in the management of type C (AO/OTA classification) fractures of the distal femur.

Patients and methods: Within a period of 4 years, 17 patients (mean age of 54 years) with intra-articular fractures of the distal femur (type C according to AO/OTA classification) were treated with retrograde IMN and compression condylar bolts. The patients followed an early mobilisation and weight-bearing protocol.

Results: All fractures healed in a mean time of 14.78 weeks with no incidences of malunion, nonunion or infections. No secondary failure of fixation occurred. Partial weight bearing was initiated in average 6.35 weeks postoperatively whilst full weight bearing in 14.6 weeks. The patients regained full extension and 117.22° of mean flexion of the knee joint while the mean New Oxford knee score was 42.05.

Conclusions: In the treatment of type C fractures of the distal femur, the combination of retrograde nailing and 'independent' compression condylar bolt (inserted prior to the nailing) provided a strong fixation that facilitated uncomplicated outcomes and uneventful early mobilisation.