The Curative Effect Analysis Of Using Retrograde Intramedullary Nails Treating Distal Femoral C Fractures

Objective: with the socio-economic development and the convenience of the transport,traffic accidents have occurred frequently in recent years,ledding to higher energy injuries increasingly.Because of the distal femoral fracture’s characteristics,plus the stretching of the ligaments and tendons,the fracture’s reduction and treatment are very difficult.Although the developments of medicine and equipment have been significantly improved,there are many other complications exist still after surgery,such as,nonunion,failure in internal fixation,knee stiffness and traumatic arthritis et al.Through analyzing the data of the treated cases of comminuted fracture of distal femur in the treatment group by GSH,in order to discuss the effect evaluation of the distal femoral C fractures’ treatment by using retrograde intramedullary nails and cannulated screws。Method: A retrospective study was done from December 2014 to October 2016 in the China-Japan Union Hospital of Jilin University,where 23 patients were treated(C1,11cases;C2,8cases;C3,4cases),aged 21 to 79 years old,the average age for 54.13 ±17.41,by cannulated compression screws and retrograde intramedullary nails,Then underwent functional training and check regularly.Preoperative preparation: Clearly without contraindications,ECG,chest radiograph,lateral knee joint and knee CT and other relevant inspection.Developing the operation programmers according to the type of fractures.All the patients had operation by general anesthesia.According to the classification and degree of comminution,determines the operative route.Finishing the reduction of femoral inter-condylar fracture at first,with hollow compression screws fixed,then treats it as a simple supracondylar fractures of the femur.Finally,we can choose the proper retrograde intramedullary nail to treat the fracture.Results: In the 24 cases,excepted 2 patients under the recent operation,the rest all fractures have good stability,without internal fixation breakage,tissue necrosis,infection and other complications.According to the Kolmert scoring criteria,Excellent in 7 cases(C1,5 cases;C2,2cases),good in 12 cases(C1,6 cases;C2,4 cases;C3,2 cases),OK,3(C2,2 cases;C3,1case),pool,1(C3),overall excellent rates: 82.61%;C1 rate 100%,C2 rate 75%,C3 rate in patients with 50%.Conclusion: Due to the less cases number of this treatment,results may exists special specific,but using Cannulated compression screws with retrograde intramedullary nails treating distal femoral c type fracture,which avoids the complications such as damage of soft tissue and periost.After surgical operation,patients’ knee function degrees can reached 90 °.Retrograde intramedullary nails plus cannulated screws can be used as a treatment method for c-type fracture of distal femur.