Long-term functional outcomes after intra-articular distal femur fractures: ORIF versus retrograde intramedullary nailing.
This retrospective study evaluated the long-term clinical, functional, and radiographic outcomes of traditional open reduction internal fixation (ORIF) versus limited open reduction with retrograde intramedullary nailing for supracondylar-intercondylar distal femur fractures (Arbeitsgemeinschaft für Osteosynthesefragen [AO] 33-C type). Twenty-three fractures were followed in 22 patients for a mean follow-up of 80 months. The rate of subsequent bone-grafting procedures (67% vs 9%) and malunion (42% vs 0%) were significantly higher in ORIF compared to the less invasive retrograde intramedullary nailing treatment. A nonsignificant trend was noted for increased infection (25% vs 0%) and nonunion (33% vs 9%) in the ORIF group. The physical function component of the SF-36 was approximately 2 standard deviations below the US population mean, and 50% of patients demonstrated radiographic changes of posttraumatic arthritis. No patient has had a subsequent total knee arthroplasty.
Thomson
A Brian
AB
Vanderbilt University, Department of Orthopedic Trauma, 2100 Pierce Ave, 131 MCS, Nashville, TN 37232, USA.
Driver
Robin
R
Kregor
Philip J
PJ
Obremskey
William T
WT
D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D005594:Fracture Fixation, Intramedullary; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome