Asian Journal of Orthopaedic Research

Background: Distal femur fractures are amongst the complex injuries of lower limb and many a times require a personalised approach. A wide range of implants have been devised to tackle this injury, amongst which nailing is a prominent procedure which includes antegrade and retrograde nailing. The aim of this study was to compare the outcome of both the techniques of distal femur fracture repair.

Methods: A prospective study of 60 patients with diaphyseal distal third femur fracture was conducted with 30 patients managed with retrograde nail and 30 patients managed with antegrade nail. All patients presenting with extra articular fractures of distal 15 cm of femur were chosen for the study. Patients were alternatively treated with retrograde and antegrade techniques. Patients were regularly followed up at 1.5,3,6 months for radiological union, partial weight bearing, full weight bearing and knee ROM.

Results: A total of 35 were male and 25 were female. Mean time for radiological union was 14 weeks for antegrade group and 10 weeks for retrograde group. Mean time for partial weight bearing was 10.9 weeks for antegrade group and 9.27 weeks for retrograde group. Average duration for full weight bearing was 18.2 weeks for antegrade group and 15 weeks for retrograde group. Mean knee ROM was 114.4 degrees with antegrade nailing and 117.3 degrees in retrograde nailing. Three patients had hip pain, two had delayed union and one had fat embolism in antegrade nailing whereas with retrograde nailing four patients had knee pain and one had delayed union.

Conclusion: Retrograde femur nailing is reliable and a superior procedure for fixation of diaphyseal distal third femur fracture when compared to antegrade femur nailing and hence can be done for fixation of these type of fractures.