Evaluation Of Femoral Alignment In Femur Distal Diaphyseal Fractures Which Treated With Intramedullary Nailling

Aim: Distal femoral fractures are common seen both elderly and young population. These fractures are % 7 of all femoral fractures. Providing of alingment after distal femoral diaphyseal fractures is important for the development of deformity and shortness. In this study, it was aimed to determine whether the effect of intramedullary nail method applied in the treatment of distal femoral diaphyseal fractures that do not extend into the joint to the femoral alignment. Patients and Methods : 62 patients were evaluated who were treated with intramedullary nail with the diagnosis of distal femoral diaphyseal fracture between 2010 and 2016. Patients has at least 1 year of follow-up. Patients were divided into 3 groups according to fracture joint distance (<100 mm, 100-130 mm, >130 mm). Nail-joint distance (NJD), fracture line-joint distance (FJD), fracture-nail distance (FND), and the translation and alignment of the fracture line were evaluated for each group. Results: In group 1; NJD 17,1±6,8 mm, FJD 78,4±17,6 mm, FND 60,8±15,9 mm, translation 4±1,3 mm, and the malalignment was 2,9±1,7°. In Group 2; NJD 19±6,8 mm, FJD 119,5±8 mm, FND 100,6±8 mm, translation 3,9±1,7 mm, and malalignment 3±1,7°. In group 3; NJD 25,2±8,7 mm, FJD 143,3±7,8 mm, FND 118,1±11,7 mm, translation 3,5±1,8 mm, and malalignment was 2,5±1,4°. Conclusion: In our study, we found that as the distance between the fracture and the joint decreased, the degree of malalignment and translation increased, and when the distance between the nail and the joint was kept below 20 mm, the amount of malalignment and translation decreased. If distal femur fractures near the joint line will be treated with intramedullary nailing attention must be taken for the malalignment and translation. Especially when the fracture-joint distance is less than 100 mm, keeping the distance between the nail and the joint below 20 mm will keep the translation and malalingment at a minimum level.