Abstract:
Background: The management of distal femoral fractures challenges the orthopaedic surgeons. The relatively high rates of complications with internal fixation resulted in the development of a different implants. In 1987, the cannulated stainless steel Green/Seligson/Henry supracondylar nail had been developed .
Materials and methods: Over a period of two and half years, thirty femoral fractures in 29 patients were treated by GSH supracondylar nail. There were 16 males (55.2%) and 13 females (44.8%) with a mean age 48.5 years (range 20 – 75 years). The AO/OTA classification system was used in 29 fractures. One case was a periprosthetic fracture above total knee replacement classified as type III according to Edward et al,. The follow up period ranged from 12 to 30 months (average 21 months). The final results were rated according to the functional score of Neer et al., (1967) which includes both functional and anatomical assessments.
Results: According to Neer et al., scoring system, 9 fractures (30%) were rated excellent, 15 (50%) were satisfactory, 5 (16.7%) were unsatisfactory and there was one failure (3.3%). Twenty nine fractures (96.7%) united at an average time of 14 weeks, while only one fracture (3.3%) passed to nonunion. Complications were infrequent. (malalignment in two cases (6.6%), two cases (6.6%) with superficial infection and three cases (9.9%) with postoperative knee stiffness).
Conclusion: The supracondylar nail is an effective method for the treatment of most of the distal femoral fractures. It provides rigid fixation through a limited incision and achieves a high rate of fracture union.