Abstract
Since 1992 we have developed an implant in which the distal (condylar) screws have
a diagonal configuration so that the screws can be closer to the distal end of the
nail, allowing more distal fractures to be fixed. It also utilises the denser bone
of the posterior condyles for more secure fixation in osteoporotic patients. The new
implant was used for 24 extra-articular fractures from September 1994 to September
1997, and for 14 articular fractures from February 1995 to December 2000. There was
no significant difficulty with obtaining fixation in very distal fractures and in
osteoporotic bone. Early weightbearing was encouraged in those with extra-articular
fractures. All fractures united within 3 months except one which required a bone graft
(but no revision of implant) at 6 months. Average knee flexion at final followup was
101° for extra-articular fractures and 106° for articular fractures. Complications
included quadriceps adhesions requiring further surgery in two patients who had open
fractures, and malunion in one patient who had an early design of the implant and
a 4.5 mm condylar screw broke. Nine patients required late removal of condylar screws due
to local soft tissue irritation.
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Article info
Publication history
Accepted:
November 26,
2001
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
