title: [Minimal invasive implant removal after retrograde intramedullary nailing of the distal femur].
abstract: Recently, the retrograde femoral nailing has become a procedure with increasing acceptance. Indications for the retrograde femur nail are distal femoral fractures including dia- and transcondylar fractures, supracondylar osteotomies and distal periprosthetic femur fractures after total knee joint replacement. Controversial discussion is carried on about the implant removal, which is potentially afflicted with further damage to the knee joint. To minimize the operative damage due to the implant removal, an arthroscopic assisted procedure has been selected. The arthroscopic assisted implant removal was possible in all of our patients. Intraoperatively, 2/3 of the patients showed normal age-related findings of the chondral and meniscal structures. The arthroscopic assisted implant removal is a gentle procedure, which allows minimal invasive extraction of retrograde femur nails and prevents secondary damage to the knee joint due to the otherwise difficult localisation of the implant. The advantages of this procedure concerning gentleness and diagnostic capabilities are as convincing, that we indicate implant removal of retrograde femur nails in all younger patients (< 60 years), except in periprosthetic fractures.
authors.affiliation: Abteilung für Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universität Ulm.
authors.forename: F
authors.initials: F
authors.lastname: Gebhard
authors.forename: S
authors.initials: S
authors.lastname: Pokar
authors.forename: G
authors.initials: G
authors.lastname: Hehl
authors.forename: W
authors.initials: W
authors.lastname: Strecker
authors.forename: L
authors.initials: L
authors.lastname: Kinzl
authors.forename: M
authors.initials: M
authors.lastname: Arand
mesh_terms: D001182:Arthroscopy; D020878:Device Removal; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation