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Knee function after complex femoral fractures treated with interlocking nails.

T J Moore¹, J Campbell, K Wheeler

¹Trauma Service, Charlotte Memorial Medical Center, North Carolina.

Clinical Orthopaedics and Related Research

|December 1, 1990

Summary

Interlocking nails for complex femoral fractures improve early motion but often result in impaired knee function, including decreased muscle strength and thigh atrophy, necessitating formal rehabilitation.

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Area of Science:

Orthopedic Surgery
Traumatology
Rehabilitation Medicine

Background:

Complex femoral fractures pose significant challenges in treatment and recovery.
Interlocking nails offer advantages in stabilizing fractures and facilitating early mobilization.

Purpose of the Study:

To evaluate long-term knee function after treating complex femoral fractures with interlocking nails.
To identify specific impairments in knee function and muscle strength post-healing.

Main Methods:

Retrospective analysis of 23 patients with complex femoral fractures treated with interlocking nails.
Assessment of knee alignment, quadriceps and hamstring strength, thigh atrophy, and range of motion (ROM) post-fracture union.

Main Results:

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While knee alignment and ROM were satisfactory, significant functional deficits were observed.
73% of patients exhibited decreased quadriceps strength, 60% had reduced hamstring strength, and 65% showed thigh atrophy.
Knee function remained impaired compared to the contralateral limb despite early mobilization benefits.

Conclusions:

Interlocking nail treatment for complex femoral fractures, while beneficial for early ROM, frequently leads to unsatisfactory knee function post-union.
A structured knee rehabilitation program is crucial for optimizing functional outcomes in these patients.