Arthroscopically assisted placement of a supracondylar intramedullary nail: operative technique

The use of retrograde interlocking intramedullary nails has been described for the treatment of selected supracondylar fractures. A medial parapatellar incision and arthrotomy with its attendant morbidity is generally used for nail placement. Although a closed technique of nail placement has been described, the risks of damaging intra-articular structures with a blind approach have precluded the widespread use of this method. In this article, we present a simple, arthroscopically assisted method for the retrograde intramedullary nailing of supracondylar femoral fractures. This technique affords the potential benefits of intramedullary fixation of these fractures while avoiding the morbidity and complications associated with an arthrotomy. Potential benefits over the standard placement using an arthrotomy include earlier ambulation and soft tissue healing, decreased risk of damage to the knee joint, earlier convalescence with decreased hospitalization time, and better cosmesis.