A Study on Intramedullary Supracondylar Interlocking Nail in the Management of Supracondylar and Intercondylar Fractures of Distal Femur

Abstract

Aim: Our aim was to treat these fractures by rigid internal fixation, allow early knee motion and to know the outcome of this IMSC nail in such fractures.Methodology: In this study we have taken 30 cases of supracondylar and inter condylar fractures of distal 15 cms of femur which are ideal for inter locking IMSC Nail.Results: The maximum number of patients were seen in the age group between 31-40 yr.Males were slightly more in number compared to females. Regarding mechanism of injury incidence for RTA is more. In young patients fracture resulted from high velocity injury and in elderly due to simple fall (low velocity injury), because of osteoporosis. Majority of the cases were simple with only 4 Compound fractures. Associated vascular and ligamentous injuries are none but other bony injuries are common. Surgery was performed by closed technique in 28 patients and Open technique in 2 patients with static locking in 28 patients and dynamic locking in 2 patients. Radiological union is seen at an average of 12 weeks. Average knee ROM observed is 1020.The complications encountered were difficulty in closed reduction due to the pull of Gastrocnemius, difficulty in proximal locking in 2 patients, infection in 2 patients of whom one had compound fracture. 2 patients had mild pain around distal Interlocking screws, and 1 patient with pathological fracture had backing out of single Interlocking screw. End results were Excellent in 14 cases, Good in 10 cases, Fair in 4 cases and poor in 2 cases according to Functional Evaluation scale. Conclusion: Analysis of our results showed that it is a good method for treating Type-A and Type-C fractures and extended indications for pathological fractures, failed distal femoral osteosynthesis and fractures in osteoporotic bones. In Type-C fractures good articular congruity is achieved by fixing the fragments with condylar screws.