Retrograde intramedullary nailing for supracondylar fractures of the femurin total knee arthroplasty

The treatment of supracondylar fractures of the femur in total knee arthrop lasty is still challenging,and a Variety of methods has been recommended. In a retrospective analysis,we reviewed six patients (average age: 70.5 yea rs) with this type of fracture that had been stabilized with a retrograde i ntramedullary locking nail [Green-Seligson-Henry (GSH) nail]. The fracture had occurred 34.5 months after implantation of total knee arthroplasty. The average lime of the operation was 97.16 min. There were no intra- or posto perative complications. All patients could be followed up at 17.3 months on average. Fracture healing was uneventful in all six cases. The postoperati ve range of motion was similar to the prefracture level in five patients. O ne patient demonstrated a loss of extension (10 degrees) associated with a valgus malalignment of 10 degrees. According to our experience, retrograde intramedullary nailing of supracond ylar fractures in total knee arthroplasty is a promising alternative, which allows closed reduction and preservation of the soft tissue envelope. Imme diate mobilization with partial weight bearing is possible,and the rate of complications is low.