title: Retrograde intramedullary nailing for distal femur fracture with osteoporosis.
abstract: BACKGROUND
  The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. Retrograde intramedullary nailing has been considered a good surgical option for distal femur fracture. The purpose of the present study was to present our surgical results with retrograde intramedullary nailing for distal femur fractures with osteoporosis.
  
  
  METHODS
  Thirteen patients diagnosed with extra-articular distal femur fracture and osteoporosis and managed with retrograde intramedullary nailing were retrospectively reviewed. Cement augmentation was used in four patients, shape memory alloy was used in eight patients and both were used in one patient. All patients were followed up for more than 2 years. Radiologic alignments were scored and Tegner and the Lysholm activity score was used for a functional assessment.
  
  
  RESULTS
  The average time to clinical union was 13 weeks (range, 10 to 15 weeks). In 12 of our cases, the total alignment scores were excellent. At the last follow-up, the mean range of motion was 116° (range, 110° to 125°). The average functional score at postoperative 1 year was 2.6 (range, 1 to 5).
  
  
  CONCLUSIONS
  Retrograde intramedullary nailing is a good surgical option for distal femur fracture with osteoporosis. Cement augmentation and shape memory alloy can also be used for added mechanical stability. This surgical technique is very useful for distal femur fracture with osteoporosis as it promotes fracture healing and early rehabilitation.
authors.affiliation: Department of Orthopedic Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Jihyeung
authors.initials: J
authors.lastname: Kim
authors.forename: Seung-Baik
authors.initials: SB
authors.lastname: Kang
authors.forename: Kyungpyo
authors.initials: K
authors.lastname: Nam
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Rhee
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Won
authors.forename: Hyuk-Soo
authors.initials: HS
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001843:Bone Cements; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000473:pathology*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D001843:Bone Cements