Clinical Result of Retrograde Intramedullary Nailing for Femoral Supracondylar Fracture in Elderly Patients

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  • 高齢者の大腿骨顆上骨折に対する逆行性髄内釘固定法の治療成績

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Abstract

We reviwed the clinical results of retrograde intramedullary nailing for femoral supracondylar fracture in elderly patients. We treated 12 patients (male: 1, female: 11) with supracondylar fracture of the femur by retrograde intramedullary nailing. All 12 fractures were classified as type A according to the AO classification. The average age was 84.8 years (72 to 96 years). Radiologically all cases united, six cases had residual valgus deformity, and three had varus one. Walking ability remained the same as the preoperative level in 10 cases. The average range of knee flexion was 96.3 degrees (70 to 130 degrees). The average shortness of the leg was 1.7 cm (0.9 to 3.3 cm). Each case was evaluated by modified Neer's clinical criteria. Excellent results were recorded in seven cases, satisfactory in three, unsatisfactory in two, and there was no failure case. There were no severe complications. We concluded that retrograde intramedullary nailing can be the first choice for type A supracondylar fracture of the femur in elderly patients. But, in patients with implant for previous femoral neck fracture, this method have some problems such as second fracture between the implants. In such cases, we may have to consider other methods.

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