COMPARISON OF SURGICAL RESULTS OF RETROGRADE INTRAMEDULLARY NAILING AND FIXING WITH PLATE SCREW IN SUPRACONDYLAR FEMUR FRACTURES

Abstract

Objective: Supracondylar femur fractures seen in adults are fractures with or without intra-articular extension and are still a difficult type of fracture to treat, although surgical fixation options are available. It constitutes 4-7% of all femur fractures. Supracondylar femur fractures are seen in the younger age group after high-energy trauma, but they can also be seen in the elderly group after low-energy or falls. After the fracture, shortening of the extremity, varus, and extension position on the distal joint surface is observed. The shortening is due to traction on the quadriceps and hamstrings. The varus and extension position depends on the pull of the unopposed adductor and the gastrocnemius. The aim here is to try to achieve the maximum anatomical reduction of the articular surface by using direct and indirect methods. However, since the soft tissue and periosteum vitality could not be preserved due to the large incisions made and a result such as nonunion was encountered, retrograde intramedullary nailing was defined in the early 90s and a sufficient number of patients were established. In this study, two groups of patients who were fixed with retrograde intramedullary nailing and plate were compared. Material and Methods: Twenty patients who were treated in our clinic between 2005 and 2016 were included in the study, 11 of these patients were treated with plate screws and 9 with retrograde nails. The subjective satisfaction level of these patients was investigated and compared in terms of postoperative VAS, HSS, Neer scores, development of arthrosis, quadriceps muscle strength, thigh atrophy, and shortness. Results: In comparison, there was no statistically significant difference between the two groups in terms of subjective satisfaction level, postoperative VAS, HSS, Neer scores, development of arthrosis, quadriceps muscle strength, thigh atrophy, and shortness. Conclusion: Plate and screw treatment and retrograde nailing methods are reliable and good treatment methods in supracondylar femur fractures, both methods have advantages and disadvantages, but there is no major difference between the two methods in terms of the patient in the long run.