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Evaluation of short term outcome on distal femoral fractures using distal femoral nail: revisiting the technique

Background: Distal femoral fractures account for 6 to 7% of all femur fractures. Ideal treatment of these fractures demands indirect reduction as well as stable fixation by implant which could tolerate the stress and strain forces till healing of fracture. Distal femoral nailing fullfils these demands.Methods: Fifteen patients with seventeen fractures were treated by this method as a prospective study at the tertiary care institute in north india. Patients were evaluated  post operatively with average follow up duration of 45.59±15.99 weeks.Results: 88% of the patients were having associated trauma. Male/female ratio was 9/8. Mean delay in surgery was 21.86±23.85 days (1-64 days). Reduction was satisfactory in all patients. Average hospital stay was 18.71±8.23 days (6-34 days). Clinical union was seen in 16 out of 17 fractures by the end of six months with average period of 4.19±0.83 months. Radiological union lagged behind clinical union with average of 5.14±0.44 months. Post operatively 5 patients with delayed union needed dynamization, 2 needed  bone grafting . One case of non union was seen. There were two cases of  infection requiring debridement. Average knee flexion was 90.35±22.95degree (50-130 degree). Average extension lag was 3.88±2.88 degree (0-10 degree). Sanders function evaluation scale at final follow up showed 11.8% excellent, 47.2% good, 23.6% fair and 17.6% poor result.Conclusions: Distal femoral nailing has good results in distal femur fracture  as the fixation is more biological and stable allowing early healing and better outcome