Comparison of antegrade locked intramedullary nails and retrograde expandable intramedullary nails in distal femur diaphysis fractures

Abstract

Aim: In this study, we aimed to compare antegrade locked and retrograde expandable intramedullary nails, which are common methods in the treatment of distal femur diaphysis fractures. Material and Methods: Twenty three femurs of 23 patients (12 males, 11 females) who underwent REN and 78 femurs of 71 patients (49 males, 22 females) who underwent ALN between January 2010 and December 2013 were included in the study. Functional outcomes were compared with HSS (Hospital for Special Surgery) and Neer scores for postoperative assesments at 24 and 48 week Results: The mean duration of bone union was evaluated as 49.7 (range 21-140) weeks in patients with ALN and 32.9 (range 13-74) weeks as the mean duration of bone union in the REN group. In the ALN group with 71 patients, 50 patients had excellent and good functional results according to Neer evaluation and 47 patients according to HSS evaluation at 48th week. In the REN group for 23 patients, excellent and good results were obtained in 14 patients for the Neer evaluation and 16 patients for HSS evaluation at the 48th week. There was no significant difference between Neer and HSS functional evaluations at 24th and 48th week between the two groups (p> 0,5); it was seen that REN application in terms of union time was significantly better than ALN (p <0,5). Discussion: ALN and REN applications are treatment options that can be used safely for distal femur fractures, and the REN option should be considered to have a significant positive effect on the duration of bone union for non-contraindicated situations.

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