Correction of femoral supracondylar varus malunions after condylar buttress plating by using retrograde locked intramedullary nailing.

Abstract

The aim of this study was to evaluate the use of retrograde locked intramedullary nailing for the treatment of varus malunion occurring following condylar buttress plating (CBP) for femoral supracondylar fractures. The study included 32 consecutive adult patients treated with retrograde locked nailing for varus malunion of femoral supracondylar fractures following CBP. Patient results were evaluated based on healing time, lower extremity alignment and knee functions. Average follow-up was 2.8 (range: 1.1 to 5.6) years for the 27 of the 32 patients who completed follow-up. All osteotomy sites healed at an average of 4.0 (range: 3.5 to 5.0) months. Average preoperative varus knee deformity was 19.6° (range: 14° to 26°). Immediate postoperative varus knee deformity was an average of 0.4° (range: valgus 2° to varus 3°) (p<0.001). At the final follow-up, the varus knee deformity was an average of 1.5° (range: valgus 1° to varus 3°) (p<0.001). Satisfactory knee function in patients improved from 0% to 93% (p<0.001). There were no serious complications. Retrograde locked nailing appears to be an excellent alternative for the treatment of varus malunion of femoral supracondylar fractures after CBP treatment. It is a simple technique with high satisfaction rates.