Functional Outcome of Distal Femur Nail Multilocking (DFN-ML) in Distal Third Femur Fractures

TL;DR

This study evaluates the effectiveness of a new method for treating femur fractures using a multilocking nail, showing improved recovery over time.

Contribution

The study presents functional outcomes of a less commonly used DFN-ML technique for distal femur fractures.

Findings

Lysholm scores improved significantly from 22.10 at four weeks to 80.65 at 12 weeks postoperatively.

DFN-ML provided sufficient stability and high union rates with early mobilization for distal femur fractures.

Postoperative complications occurred in 19.4% of patients.

Abstract

Background

Distal femur fractures (DFFs) are relatively common injuries, particularly in younger individuals due to high-energy trauma and in older individuals due to lower-force events and poor bone quality. Distal femur nail multilocking (DFN-ML) is a less commonly reported method of fixation with potential biomechanical advantages. This method involves the use of an intramedullary nail that has multiple directional locking screws, which provide better stability and fixation compared to conventional plating and nailing methods.

Objective

The present study aimed to evaluate the functional outcome of patients treated with DFN-ML for distal third femur fractures.

Methodology

A total of 31 patients with distal third femur fractures were included in the study. Preoperatively, patients were evaluated to classify the fracture according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Range of movement exercises were started from postoperative day (POD) 3, and partial weight-bearing was started from POD 4. Functional outcomes were assessed using the Lysholm Knee Scoring Scale at four, eight, and 12 weeks postoperatively.

Results

The mean age of the patients was 43.55±21.52 years. The majority of the patient population was male (71%). Road traffic accident (RTA) was the most common injury mode reported in 58.1% of cases. The mean Lysholm score increased significantly from four weeks (22.10±13.41) to eight weeks (41.06±15.28) and 12 weeks (80.65±12.24). Postoperative complications were observed in six (19.4%) patients.

Conclusion

The DFN-ML technique appears to offer sufficient stability, high union rates, and early mobilization for the treatment of DFFs. Our findings suggest that DFN-ML is a viable method that may promote fracture healing by providing robust fixation and enabling early mobilization. Larger multicentric studies with longer follow-up are recommended to validate these results.

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