SICOT Global Network for Electronic Learning - SIGNEL

Article of the Month - SICOT-J

Retrograde nailing for distal femur fractures in the elderly

Jasdeep Giddie, Seif Sawalha and Martyn Parker
Department of Orthopaedics, Peterborough and Stamford Hospital NHS Foundation Trust, Peterborough City Hospital, Bretton Gate, PE3 9GZ Peterborough, UK 


Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail.

Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint.

Results: The mean age of patients was 80.6 years (range 51–103 years), 52/54 (96%) were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3%) and the one year mortality was 17/54 (31.5%).

Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

Key words: Distal femur fracture / Retrograde nail / Union / Complications / Mortality