Abstract:
Background The management of distal femoral fractures
challenges orthopedic surgeons. The relatively high rates of
complications with internal fixation resulted in the development of different implants. In 1987, the cannulated
stainless steel Green/Seligson/Henry (GSH) supracondylar
nail had been developed.
Materials and methods Over a period of 2.5 years, 30
femoral fractures in 29 patients were treated by the 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 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association 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. (J Am Acad Orthop Surg 12: 12–20, 2004). 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. (J Bone Joint Surg 49(A): 591–613, 1967) which include 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 1 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.